RT Journal Article
SR Electronic
T1 Late recurrences of Sydenham’s chorea are not associated with anti-basal ganglia antibodies
JF Journal of Neurology, Neurosurgery & Psychiatry
JO J Neurol Neurosurg Psychiatry
FD BMJ Publishing Group Ltd
SP 1478
OP 1479
DO 10.1136/jnnp.2003.030775
VO 75
IS 10
A1 N A Harrison
A1 A Church
A1 A Nisbet
A1 P Rudge
A1 G Giovannoni
YR 2004
UL http://jnnp.bmj.com/content/75/10/1478.abstract
AB Anti-basal ganglia antibodies (ABGA) have been associated with 100% of acute cases and 69% of persistent cases of Sydenham’s chorea. We describe two cases of late recurrences of Sydenham’s chorea with absence of ABGA. Both patients had several childhood episodes of Sydenham’s chorea. MRI imaging of the basal ganglia and exhaustive investigations for other causes of chorea were normal or negative. The absence of ABGA may be evidence against an autoimmune pathology in late and some persistent recurrences. We suggest the likely pathophysiology to be dopamine hypersensitivity of chronically damaged basal ganglia neurones possibly following induction of an autoimmune antibody response in childhood.