Perspectives on Psychiatric Features of Sydenham Chorea.

Mendelman, Lisa; Dale, Russell C; Mackenzie, Katherine; Bostwick, J Michael; Wald, Ellen R; Sanger, Terence; Miles, Kate; Kendell, Sarah et al. · Pediatrics · 2026

review · Level V

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Abstract

Sydenham chorea (SC) has been conventionally recognized as a movement disorder that occurs in 10%-50% of pediatric patients with acute rheumatic fever. In this article, we review the research on SC's psychiatric aspects and detail how physicians writing in English have grappled with questions of SC's psychological and somatic etiology and symptoms over the past 150 years. We demonstrate that the current neuropsychiatric understanding of SC in Anglophone contexts is the result of decades of scientific dialogue, with its mental, emotional, and behavioral symptoms now identified as a feature of organic pathology. This examination provides a valuable perspective on the challenges of interpreting and understanding the central nervous system manifestations of autoimmune illness caused by Group A Streptococcus.