Rheumatic fever with chorea

Asbahr, F.R., Negrao, A.B., Gentil, V., Zanetta, D.M., da Paz, J.A., Marques-Dias, M.J., and Kiss, M.H. (1998) Obsessive-compulsive and related symptoms in children and adolescents with rheumatic fever with and without chorea a prospective 6-month study. Am J Psychiatry 155 1122-1124. 

Husby, G., van de Rijn, L, Zabriskie, J.B., Abdin, Z.H., and Williams, R.C., Jr. (1976) Antibodies reacting with cytoplasm of subthalamic and caudate nuclei neurons in chorea and acute rheumatic fever. / Exp Med 144 1094—1110. 

In ten children with chorea (eight girls and two boys aged 7-16 years), nine with rheumatic fever, carbamazepine (4-10 mg/kg/day plasma concentrations 12-34 pmol/l) produced improvement within 2-14 days (1). The chorea disappeared within 2-12 weeks. There were no adverse effects. 

In those patients who develop chorea, the typical neurological complication of rheumatic fever, antibodies against the caudate nucleus of the central nervous system are present. These antibodies correlate with clinical disease activity. 

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