Chorea paralytica (or chorea mollis) is a very rare variant of Sydenham’s chorea, characterized by a profound hypotonia, resulting in severe disability. Given the rarity of this condition, data on its prognosis are lacking. Most reports suggest that the delay from onset to recover total autonomy is long, usually several weeks to months which strongly affects the quality of life of these children. We report a videotape case of a 14-year-old girl, who became rapidly bedridden because of severe generalized chorea paralytica. Her clinical picture was totally improved 7 days only after initiation of an “aggressive” treatment, combining steroid pulse, haloperidol and long-term penicillin G, with no relapse after 4-year follow-up. We believe that the best care of this rare and severe form of Sydenham’s chorea, should combine pathophysiological treatment with corticosteroids, preferably by pulse-therapy, symptomatic antichoreic treatment by neuroleptics, associated with a long-term antibiotic use to reduce recurrence risk.
This is a preview of subscription content, log in to check access.
Buy single article
Instant unlimited access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
Cardoso F (2008) Sydenham’s chorea. Curr Treat Options Neurol 10:230–235
Gordon N (2009) Sydenham’s chorea, and its complications affecting the nervous system. Brain Dev 31:11–14
Bruyn GW, Voswinckel P (2002) The Gordon–Hey reflex. J Hist Neurosci 11:174–179
Gowers WR (1881) On paralytic chorea. Br Med J 1:636–637
Bernsen PL, Renier WO (1990) Chorea mollis, a rare variant of chorea minor. Tijdschr Kindergeneeskd 58:94–99
Shah DR, Bhatnagar HN, Arora SK (1977) Chorea mollis with carditis. J Indian Med Assoc 68:210–212
Balottin U, Calcaterra E, Zambonin F, Veggiotti P, Luoni C, Termine C (2012) Chorea mollis: long-term follow-up of an infantile case. Neurol Sci 33:643–645
Teixeira AL Jr, Maia DP, Cardoso F (2005) Treatment of acute Sydenham’s chorea with methyl-prednisolone pulse-therapy. Parkinsonism Relat Disord 11:327–330
Daoud AS, Zaki M, Shakir R, al-Saleh Q (1990) Effectiveness of sodium valproate in the treatment of Sydenham’s chorea. Neurology 40:1140–1141
Conflict of interest
Electronic supplementary material
Below is the link to the electronic supplementary material.
About this article
Cite this article
El Otmani, H., Moutaouakil, F., Fadel, H. et al. Chorea paralytica: a videotape case with rapid recovery and good long-term outcome. Acta Neurol Belg 113, 515–517 (2013). https://doi.org/10.1007/s13760-013-0214-6
- Chorea paralytica
- Chorea mollis
- Sydenham’s chorea