title: Acute and chronic corticosteroid treatment of ten patients with paralytic form of Sydenham's chorea.
abstract: OBJECTIVE
  To determine efficacy and safety of corticosteroid treatment in patients with severe Sydenham's chorea paralytic form.
  
  
  METHODS
  This is a 4 years observational study on ten patient with severe paralytic form of Sydenham's chorea unresponsive to neuroleptics and antiepileptics agents, treated with intravenous methylprednisolone followed by oral deflazacort therapy. Chorea paralytica patients were bedridden, unable to take independent steps, showed severe generalized hypotonia and were hospitalized for 3-4 weeks. Additional clinical evaluations were undertaken at 1, 3 and 6 months and 1, 2 and 4 years from onset of chorea. Severity chorea at the onset and during follow up was rated according to Universidade Federal de Minas Gerais (UFMG) Sydenham's Chorea Rating Scale (USCRS). In all children video-recording was performing at onset and during clinical follow-up.
  
  
  RESULTS
  We reported a significant improvement in swallowing and chewing with partial recovery of language 2-3 days after starting intravenous methylprednisolone treatment and complete disappearance of movement disorders after 3-4 weeks of treatment. All our patients were followed for 4 years from onset and none experienced relapse of chorea, other movement disorders or psychiatric disturbances. The treatment with deflazacort was well-tolerated in all children with no significant side effects reported.
  
  
  CONCLUSIONS
  Our data showed that high dose of methylprednisolone intravenously followed by deflazacort therapy may be effective and well-tolerated in children with severe paralytic form of Sydenham's chorea.
authors.affiliation: Pediatric Neurology Unit, Arcispedale Santa Maria Nuova, V.le Risorgimento 80, 42123 Reggio Emilia, Italy. fusco.carlo@asmn.re.it
authors.forename: Carlo
authors.initials: C
authors.lastname: Fusco
authors.forename: Valentina
authors.initials: V
authors.lastname: Ucchino
authors.forename: Daniele
authors.initials: D
authors.lastname: Frattini
authors.forename: Francesco
authors.initials: F
authors.lastname: Pisani
authors.forename: Elvio
authors.initials: E
authors.lastname: Della Giustina
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D017668:Age of Onset; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D000927:Anticonvulsants / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D000989:Antistreptolysin / Q000378:metabolism; D002648:Child; D002819:Chorea / Q000188:drug therapy* / Q000523:psychology; D003679:Deglutition; D005260:Female; D006801:Humans; D008297:Male; D008409:Mastication; D008775:Methylprednisolone / Q000627:therapeutic use; D009069:Movement Disorders / Q000188:drug therapy / Q000209:etiology; D009205:Myocarditis / Q000150:complications; D009460:Neurologic Examination; D010243:Paralysis / Q000188:drug therapy / Q000209:etiology; D011282:Pregnenediones / Q000627:therapeutic use; D012213:Rheumatic Fever / Q000150:complications
chemical_list: D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D000927:Anticonvulsants; D014150:Antipsychotic Agents; D011282:Pregnenediones; D000989:Antistreptolysin; C021988:deflazacort; D008775:Methylprednisolone