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Chorea paralytica: a videotape case with rapid recovery and good long-term outcome

Abstract

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.

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Correspondence to Hicham El Otmani.

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Video 1: generalized chorea and marked hypotonia resulting in severe disability (WMV 17487 kb)

Video 2: 1 week after starting treatment, this girl has recovered total autonomy (WMV 9034 kb)

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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

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  • DOI: https://doi.org/10.1007/s13760-013-0214-6

Keywords

  • Chorea paralytica
  • Chorea mollis
  • Sydenham’s chorea
  • Hypotonia
  • Prognosis