title: Neuropsychological manifestations in children with Sydenham's chorea after adjunct intravenous immunoglobulin and standard treatment.
abstract: This was an exploratory study comparing neuropsychological manifestations of Sydenham's chorea (SC), 6 months after initiation of treatment, in children who had received intravenous immunoglobulins as an adjunct to standard treatment, with those who had received standard treatment. We included a non-SC control group for comparison. We hypothesized that compared to controls, children with SC who had received prior intravenous immunoglobulins would demonstrate less pronounced impairments compared to those who had received standard care. We conducted a cross-sectional analysis of 17 children with -SC who had received treatment 6 months previously (9 treated with standard of care and 8 augmented with intravenous immunoglobulins) and 17 non-SC, medically well controls. The standard treatment group (n = 9) exhibited significant behavioral difficulties, including significantly poorer co-operation (p = 0.009) compared with the other augmented immunoglobulins and non-SC control groups, and increased impulsivity (p = 0.016) compared with non-SC controls. The standard treatment group scored significantly lower than the other two groups on a measure of executive functioning (p = 0.03). Children with SC may be more at risk for neuropsychological difficulties than non-SC, medically well children. Intravenous immunoglobulins may mitigate some of these impairments.
authors.affiliation: Department of Psychiatry, University of Stellenbosch, P.O. Box 19063, Tygerberg, 7505, South Africa.
authors.forename: Claire
authors.initials: C
authors.lastname: Gregorowski
authors.affiliation: US/UCT MRC Unit on Anxiety & Stress Disorders, Department of Psychiatry, University of Stellenbosch, Tygerberg, South Africa.
authors.forename: Christine
authors.initials: C
authors.lastname: Lochner
authors.affiliation: Department of Psychiatry, University of Stellenbosch, P.O. Box 19063, Tygerberg, 7505, South Africa.
authors.forename: Lindi
authors.initials: L
authors.lastname: Martin
authors.affiliation: Department of Psychiatry, University of Stellenbosch, P.O. Box 19063, Tygerberg, 7505, South Africa. csimmons@sun.ac.za.
authors.forename: Candice
authors.initials: C
authors.lastname: Simmons
authors.affiliation: Centre for Statistical Consultation, Department of Statistics & Actuarial science, University of Stellenbosch, Tygerberg, South Africa.
authors.forename: Martin
authors.initials: M
authors.lastname: Kidd
authors.affiliation: Department of Paediatric Neurology, Red Cross War Memorial Children's Hospital, School of Child and Adolescent Health, University of Cape Town, Cape Town, South Africa.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Walker
authors.affiliation: Department of Paediatric Neurology, Red Cross War Memorial Children's Hospital, School of Child and Adolescent Health, University of Cape Town, Cape Town, South Africa.
authors.forename: Jo M
authors.initials: JM
authors.lastname: Wilmshurst
authors.affiliation: Department of Psychiatry, University of Stellenbosch, P.O. Box 19063, Tygerberg, 7505, South Africa.|US/UCT MRC Unit on Anxiety & Stress Disorders, Department of Psychiatry, University of Stellenbosch, Tygerberg, South Africa.
authors.forename: Soraya
authors.initials: S
authors.lastname: Seedat
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D002648:Child; D002653:Child Behavior Disorders / Q000209:etiology / Q000523:psychology; D002675:Child, Preschool; D002819:Chorea / Q000188:drug therapy* / Q000473:pathology* / Q000523:psychology; D003299:Cooperative Behavior; D003430:Cross-Sectional Studies; D056344:Executive Function; D005260:Female; D006220:Haloperidol / Q000627:therapeutic use; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007175:Impulsive Behavior; D008297:Male; D009483:Neuropsychological Tests; D010406:Penicillins / Q000627:therapeutic use; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D014150:Antipsychotic Agents; D016756:Immunoglobulins, Intravenous; D010406:Penicillins; D006220:Haloperidol
keywords: Intravenous immunoglobulins; Neuropsychiatric; Neuropsychological; Sydenham’s chorea; Treatment