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December 14, 1994

Sydenham's ChoreaA Model for Childhood Autoimmune Neuropsychiatric Disorders

Author Affiliations

From the Section on Behavioral Pediatrics, Child Psychiatry Branch, National Institute of Mental Health, Bethesda, Md.

JAMA. 1994;272(22):1788-1791. doi:10.1001/jama.1994.03520220082035

SELECTED CASE  Faith (not her real name), a 9-year-old girl, presented to the local hospital's emergency department with a chief complaint of "St Vitus' dance." Her grandfather had noticed her clumsy gait and frequent jerky movements and had concluded that "she must have St Vitus' dance, just like her Aunt Cecilia did when she was 7." In retrospect, Faith had at least a 2-week history of increasing fidgetiness, clumsiness, and subtle choreiform movements. During the week prior to presentation, she had noticed a deterioration in her handwriting skills and had been having increasing difficulties with speaking, walking, and such daily activities as brushing her teeth, manipulating a fork, and drinking from a glass.About a month prior to presentation, Faith had experienced the abrupt onset of nightmares and of anxiety about being separated from her mother. At about the same time, she began to wash her hands excessively (up to

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