SYDENHAM'S chorea is a symptom complex of distinctive, involuntary, purposeless or quasi-purposeless movements which are intensified by voluntary effort or by excitement and which disappear during sleep. The illness is self-limiting and is unassociated with sensory or sphincter disturbances or with progressive mental deterioration. There is frequently an associated emotional instability.35
Lewis-Jonsson23 has suggested its classification into rheumatic, nonrheumatic, and cryptogenetic types. The nonrheumatic choreas include those due to systemic lupus erythematosus,1,30 hypoparathyroidism,27 and vascular or neoplastic lesions of the central nervous system.24 The cryptogenetic choreas occur in the absence of associated major manifestations of rheumatic fever or a history of prior rheumatic disease and without signs of a definite nonrheumatic cause. Though some authors16 favor the term pure chorea for this group and feel there is no relationship to the rheumatic state, others7,36 find fault with this theory. Since a significant number