Abstract
We describe the long-term follow-up of a patient affected by chorea mollis, a rare variant of Sydenham’s chorea of which there are very few reports in the literature. Our patient, a previously healthy 8-year-old boy developed progressive clumsiness, gait disturbance, generalised hypotonia and muscle weakness, choreic movements of the limbs and behavioural disturbances. Following the diagnosis of chorea mollis, the patient received prophylaxis (monthly injections of benzathine benzyl penicillin). Within a few weeks, his clinical conditions worsened and he became bedridden and incapable of standing and walking without assistance. The choreic movements were successfully treated with sodium valproate. Independent walking was achieved 14 months after the onset of the disease. At a 4-year follow-up, the patient showed a full neurological and psychiatric recovery. The clinical course observed in our patient shows that chorea mollis may not only have a dramatic course, but also have a good long-term prognosis.
Similar content being viewed by others
References
Fernandez-Alvarez E, Aicardi J (2001) Movement disorders in children. MacKeith Press, London
Dajani AS, Ayoub E, Bierman FZ, Bisno AL, Denny FW, Durack DT (1992) Guidelines for the diagnosis of rheumatic fever (Jones Criteria, 1992 Update). JAMA 268:2069–2073
Gowers WR (1881) On paralytic chorea. Br Med J 1:636–637
Thiebaut F (1968) Diseases of the basal ganglia. In: Vinken PJ, Bruyn GW (eds) Handbook of clinical neurology, vol 6. North Holland/Wiley, Amsterdam/New York, p 427
Aron AM, Freeman JM, Carter S (1965) The natural history of Sydenham’s chorea. Review of the literature and long-term evaluation with emphasis on cardiac sequelae. Am J Med 38:83–95
Manchanda SS, Paul R (1968) Sydenham’s chorea. Aetiological and clinical observations on 115 cases. Indian J Pediatr 35:523–525
Shah DR, Bhatnagar HN, Arora SK (1977) Chorea mollis with carditis. J Indian Med Assoc 68:210–212
Díaz-Grez F, Lay-Son L, del Barrio-Guerrero E, Vidal-González P (2004) Sydenham’s chorea. A clinical analysis of 55 patients with a prolonged follow-up. Rev Neurol 39:810–815
Cardoso F, Eduardo C, Silva AP, Mota CC (1997) Chorea in fifty consecutive patients with reumatic fever. Mov Disord 12:701–703. doi:10.1002/mds.870120512
Gordon N (2009) Sydenham’s chorea, and its complications affecting the nervous system. Brain Dev 31:11–14. doi:10.1016/j.braindev.2008.05.001
Genel F, Arslanoglu S, Uran N, Saylan B (2002) Sydenham’s chorea: clinical findings and comparison of the efficacies of sodium valproate and carbamazepine regimens. Brain Dev 24:73–76
Pena J, Mora E, Cardozo J, Molina O, Montiel C (2002) Comparison of the efficacy of carbamazepine, haloperidol and valproic acid in the treatment of children with Sydenham’s chorea: clinical follow-up of 18 patients. Arq Neuropsiquiatr 60:374–377
Cardoso F (2008) Sydenham’s chorea. Curr Treat Options Neurol 10:230–235
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Balottin, U., Calcaterra, E., Zambonin, F. et al. Chorea mollis: long-term follow-up of an infantile case. Neurol Sci 33, 643–645 (2012). https://doi.org/10.1007/s10072-011-0806-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10072-011-0806-y