SYDENHAM'S CLASSICAL DESCBIPTION of Chorea is now buried some 277 years in the archives of medical history, and yet the pathogenesis of chorea is still a matter of contention. The association of chorea and rheumatic fever was first described by Bright in 1831 and classical early endorsements of this association were added by Boger in 1868 and by Osier in 1887. From these earliest beginnings, however, there was a small but persistent minority who insisted on the primacy of nonrheumatic factors in the causation of chorea. The basis for this disagreement was the propensity of chorea to occur when the evidence for general rheumatic infection was absent. Because of this frequent lack of other clinical and laboratory evidence for rheumatic fever, chorea has been described as a "mild manifestation of rheumatic fever," a "late manifestation of rheumatic fever," a "major manifestation," and "the manifestation of rheumatic fever in the neurotic
Diamond EF, Tentler R. The Electroencephalogram in Rheumatic Fever. JAMA. 1962;182(6):685–687. doi:10.1001/jama.1962.03050450085020c
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