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On defining Sydenham's chorea: where do we draw the line?
T K Murphy1, W K Goodman, E M Ayoub
1Department of Psychiatry, University of Florida, College of Medicine, Gainesville 32610-0256, USA.
Biological Psychiatry
|May 16, 2000
Summary
Sydenham's chorea (SC) involves neuropsychiatric symptoms, some shared with Tourette's syndrome and OCD. PANDAS, a related condition, is a useful concept but not yet a subset of SC.
Area of Science:
- Neuroscience
- Pediatrics
- Rheumatology
Background:
- Sydenham's chorea (SC) is a rheumatic fever manifestation with diverse neuropsychiatric symptoms.
- Overlapping symptoms exist between SC, Tourette's syndrome, and childhood-onset obsessive-compulsive disorder (OCD).
- Genetic factors may influence susceptibility to these conditions.
Purpose of the Study:
- To explore the relationship between PANDAS and Sydenham's chorea.
- To determine if PANDAS should be classified as a subset of SC.
- To discuss the diagnostic implications for neuropsychiatric disorders.
Main Methods:
- Literature review and conceptual analysis.
- Comparison of clinical presentations and proposed etiologies.
- Discussion of diagnostic criteria and nosology.
Main Results:
- PANDAS shares some features with SC but has distinct characteristics.
- Current evidence does not support subsuming PANDAS under SC.
- PANDAS is considered a useful diagnostic construct.
Conclusions:
- PANDAS is a valuable concept for describing specific pediatric neuropsychiatric conditions.
- Expanding SC to include PANDAS is premature.
- Further research is needed to clarify the relationship between these disorders.
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