Sydenham's Chorea

Sydenham's chorea is a delayed complication of group A beta haemolytic streptococcal infections and forms one of the major criteria of acute rheumatic fever. It is characterised by chorea, muscular weakness, and a number of neuropsychiatric symptoms. It is considered to be an autoantibody mediated disorder with the evidence suggesting that patients with Sydenham's chorea produce antibodies that cross react with streptococcal, caudate, and subthalamic nuclei. However, documented evidence of previous streptococcal infection is found in only 20%-30% of cases. It has a good prognosis for full recovery so treatment is not warranted in most cases. Following case is a high school student presented with progressive changes in his handwriting during two months before. Chief complaint of this 15-year-old boy was difficulty in writing at classroom. His physics notebook has been shown as interesting figures.