Sydenham’s Korea: Causes, Symptoms, and Treatment

Sydenham’s Korea is a rare neurological disease, Produced by infection of a bacteria called b-hemolytic group A streptococcus. Its main symptom is impaired movement. This disease was first described by an English physician, Thomas Sydenham, in 1686.

In this article, we tell you what this disease is, relevant data and what are its causes, symptoms and treatments.

    Sydenham Korea: definition and general characteristics

    Sydenham’s Korea is a rare neurological disease. The other names he receives are: Little Korea, Rheumatic Korea or Saint-Vitus dance. It is a movement disorder, caused by the infection of certain bacteria belonging to group A “Streptococcus”.

    As for its characteristics, it is degenerative, non-progressive, inflammatory disease of the central nervous system (CNS); remember that the CNS is made up of the brain (brain) and the spinal cord.

    Its onset is usually insidious and of limited duration. Compared to its evolution, it is variable and difficult to define. Its disappearance is generally gradual. Symptoms can last for about 3 months, although in some cases they can last up to 6 to 12 months.

    In contrast, the movements that appear in Sydenham’s Korea have no apparent goal, they are non-repetitive and involuntary. These movements eventually disappear and luckily they leave no neurological after-effects.. Depending on the case, the symptoms may be more severe or milder, and may even consist only of transient mental disorders, such as: emotional instability, restlessness and irritability.

    This disorder appears more frequently in girls who have not yet reached puberty. However, Sydenham’s Korea can also appear in children.

    A little history …

    Sydenham’s Korea appeared over 600 years ago as an epidemic (c. 1418). However, it was not until 1686 that an English physician, Thomas Sydenham, described the disease.

    Later, Richard Bright, another English physician, in 1831 was the one who discovered that Sydenham’s Korea was associated with rheumatic fever (EN), And so he described it.

    more data

    When does Sydenham Korea usually appear? It all depends on the age at which the person is infected with the bacteria, of course, although this age varies from six to 15 years. These patients usually have a history of rheumatism or heart disease.

    Its frequency is more important, as we advance, in females. In fact, in adolescence, those affected by Sydenham Korea are virtually all women.

    the causes

    As we have already mentioned, the cause of Sydenham’s Korea is infection with bacteria belonging to group A Streptococcus. Strep is a type of bacteria that causes other conditions such as rheumatic fever and strep throat. Specifically, this bacterium responsible for Sydenham’s Korea is called group A b-hemolytic streptococci.

    How do these types of group A bacteria work? Interact with a specific area of ​​the brain: the basal ganglia (involved in movement, posture and speech). So, by a reaction of this brain structure, Korea is originally from Sydenham.

    On the other hand, Sydenham’s Korea affects about 10% of people with rheumatic fever. This association is linked to the body’s autoimmune mechanisms.

    symptoms

    In fact, Sydenham’s Korea is actually a symptom (rather a sign) of another condition, caused by group A of the Streptococcus bacteria; this condition is acute rheumatic fever (EN).

    There are two options: either the person has the fever or has recently had it.. Some people with RF show only this sign, Sydenham Korea, while others show others.

    Regarding the symptoms that accompany this disease (which usually lasts 3 months, with cases up to 6 and 12), we find the following four:

    1. Movement disorders

    We have said that the main alteration in Sydenham Korea is movement disorder. Thus, movements appear which have the following characteristics: they have no apparent goal (that is to say, they are “meaningless” movements), they are not repetitive, they are involuntary, rapid , poorly coordinated and abrupt. Their duration is limited and they do not leave neurological sequelae.

    These movements disappear during sleep, and they affect any muscle group (Less eye muscles, eyes). Also, it should be clarified that in mild cases of Sydenham Korea, patients simply have difficulty dressing and feeding themselves, in addition to an awkward appearance.

      2. Psychic alterations

      Another symptom of Sydenham’s Korea is transient psychic alterations. The most common are three: emotional instability, restlessness and irritability.

      3. Rheumatic fever

      As we have seen, rheumatic fever is another of the symptoms of Korea (or one of its signs), which also appears as a result of group A streptococcal infection. It is an inflammatory disease that can damage the heart, skin, brain, and joints.

      4. Rheumatic carditis

      In contrast, a third of cases in Korea are associated with another symptom: rheumatic carditis. It consists of a condition that causes permanent damage to the heart valves.

      treatment

      Regarding Sydenham’s treatment of Korea at the present time there is no drug that is 100% effective in all cases in Korea.

      On the other hand, when the condition is severe, it is sometimes necessary to sedate the patient, in order to protect him from self-harm that might be caused by Korea (for example, hitting his arms and legs).

      Although there are no drugs that are 100% effective in all cases in Korea, there are drugs that can alleviate the symptoms. Depending on their severity, four options are generally used:

      1. Phenobarbital

      Phenobarbital is a barbiturate and is the drug of choice to treat Sydenham’s Korea. It is administered orally and your prescription is kept for as long as it takes to rule out abnormal movements. Its efficiency is around 80%.

      2. Diazepam

      Diazepam is a benzodiazepine (anxiolytic), which is usually the second option. In other words, that is to say it is given in case of failure of phenobarbital.

        3. Haloperidol

        In the third option to treat Sydenham Korea, we have haloperidol, a type of antipsychotic. It is used when the above drugs have not worked. however, in children it is very toxic.

        4. Corticosteroids?

        Corticosteroids have also been used in some cases, although they have not been 100% shown to improve symptoms in Korea.

        Bibliographical references:

        • Avellaneda, A. and Izquierdo, M. (2004). FEDER (Spanish Federation of Rare Diseases). (2004).
        • Díaz-Grez, F. Lay-Són, L., De el Barri-Guerrero, E. and Vidal-González, P. (2004). Sydenham Korea. Clinical analysis of 55 patients with prolonged follow-up. Rev Neurol, 39 (9): 810-815.
        • MedLinePlus. (2019). Sydenham Korea.

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