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Treatment of Sydenham chorea with corticosteroids

Authors

  • Francisco Cardoso MD, PhD,

    Corresponding author
    1. Movement Disorders Clinic, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
    • Movement Disorders Clinic, Hospital das Clínicas, Universidade Federal de Minas Gerais, Av Pasteur 89/1107, 30150-290 Belo Horizonte MG, Brazil
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  • Débora Maia MD,

    1. Movement Disorders Clinic, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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  • Mauro César Q.S. Cunningham MD,

    1. Movement Disorders Clinic, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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  • Guilherme Valença MD

    1. Movement Disorders Clinic, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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Abstract

Despite treatment with valproic acid and neuroleptics, a significant proportion of patients with Sydenham chorea (SC) remain with chorea. We evaluated the effect of intravenous methyl-prednisolone followed by oral prednisone in patients with SC refractory to conventional treatment. Patients were enrolled in the study if they failed to improve with conventional treatment, despite the development of side effects. Chorea was rated on a 0 to 4 score. Five patients, 3 of them women, were included in the study. The median pretreatment rating score of the chorea was 3 (range, 3–4) and dropped to 1 (range, 0–2) after a median follow-up of 7 months (range, 3–7 months). Two patients developed Cushing syndrome. Our data suggest that intravenous methyl-prednisolone followed by oral prednisone is an effective and well-tolerated treatment of refractory SC. © 2003 Movement Disorder Society

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