Abstract
Sydenham's Chorea (SC) is an early complication of rheumatic fever caused by group
A beta-hemolytic streptococcal infection that manifests itself with adventitious choreatic
movements and behavioral problems. Sensory phenomena are the premonitory sensory experiences
that are described prior to tics. Tic disorders and SC share common underlying neurobiological
substrates, yet sensory phenomena have not previously been examined in SC. We aimed
to explore the presence of sensory phenomena associated with choreatic movements in
children with SC. Thirteen SC patients are examined on measures of sensory phenomena
using a semi-structured instrument. 10 out of 13 patients described sensory phenomena.
Five of the SC patients described sensory phenomena as “between physical and mental”.
The patients described physical feelings of tension in joints, tingling and trembling
sensations on skin. 69 % of them described movements as “completely involuntary”.
Sites of choreatic movements that were consistently preceded by sensory phenomena
were upper and lower extremities, and trunk. Children may have difficulty in articulating
sensory phenomena due to the subjective nature of premonitory feelings in SC. We recommend
exploring the sensory experiences that might accompany the choreatic movements in
children with SC.
Key words
Sydenham's chorea - sensory phenomena - basal ganglia-related disorders - neuropsychiatric
- child
References
- 1
Banaschewski T, Woerner W, Rothenberger A.
Premonitory sensory phenomena and suppressibility of tics in Tourette syndrome: developmental
aspects in children and adolescents.
Dev Med Child Neurol.
2003;
45
700-703
- 2
Cohen A J, Leckman J F.
Sensory phenomena associated with GTS.
J Clin Psychiatry.
1997;
53
319-323
- 3 Fenichel G M.
Movement disorders. Fenichel GM, Fenichel M Clinical Pediatric Neurology. A Signs and Symptoms Approach. Pennsylvania;
W. B. Saunders Co 1993: 285-301
- 4
Ghika J, Regli F, Growdon J H.
Sensory symptoms in cranial dystonia: A potential role in etiology.
J Neurol Sci.
1993;
116
142-147
- 5
Husby G, Rjn I, Zabriskie J B.
Antibodies reacting with cytoplasm of subthalamic and caudate nuclei neurons in chorea
and acute rheumatic fever.
J Exp Med.
1976;
144
1094-1110
- 6
Koller W C.
Sensory symptoms in Parkinson's disease.
Neurology.
1984;
34
957-959
- 7
Koller W C, Biary N.
Volitional control of involuntary movements.
Movement Disord.
1989;
4
153-156
- 8
Kurlan R, Lichter D, Hewitt D.
Sensory tics in Tourette syndrome.
Neurology.
1989;
39
731-734
- 9
Leckman J F, Walker D E, Cohen D J.
Premonitory urges in Tourette's syndrome.
Am J Psychiatry.
1993;
150
98-102
- 10
Lang A.
Patient perception of tics and other movement disorders.
Neurology.
1991;
41
223-228
- 11
Miguel E C, Coffey B J, Baer L.
Phenomenology of intentional repetitive behaviors in OCD and TS.
J Clin Psychiatry.
1995;
56
246-255
- 12
Miguel E C, Rosario-Campos M C, Prado H S.
Sensory phenomena in obsessive compulsive disorder and Tourette's disorder.
J Clin Psychiatry.
2000;
61
150-156
- 13
Mercatande M T, Rosario-Campos M C, Marquies-Dias M J.
Vocal tics in Sydenham's chorea (letter).
J Am Acad Child and Adolesc Psychiatry.
1997;
36
305
- 14
Rodopman-Arman A, Yazgan M Y, Zaimoglu S.
Sensory phenomena as an associate of Tourette syndrome.
Turk Psikiyatri Derg.
1998;
9
247-256
- 15
Scahill L D, Leckman J F, Marek K L.
Sensory phenomena in Tourette syndrome.
Advances in Neurology.
1995;
65
273-280
Assistant Prof. M. D. Ayse Rodopman-Arman
Cemil Topuzlu Cad
Kazim Lakay Sok
Sumer Apt. No: 18/10
34726 Ciftehavuzlar
Istanbul
Turkey
Email: aarman@marmara.edu.tr