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June 1979

Sydenham's Chorea and Epileptic Seizures

Author Affiliations

University of Utah College of Medicine Salt Lake City, UT 84132

Arch Neurol. 1979;36(6):388. doi:10.1001/archneur.1979.00500420098022

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To the Editor.—  I would like to express my sincere and serious doubts about the implications of the report suggesting a significant association between Sydenham's chorea and epileptic seizures (Arch Neurol 35:382-385, 1978). I would agree completely with the authors' opening statement, "The observation of convulsion during Sydenham's chorea has not been well documented." The authors describe two choreic children who exhibited episodic behavioral abnormalities during the course of chorea in conjunction with EEG abnormalities and conclude that the patients had "complex partial seizures."I am not convinced of their conclusions for several reasons. In any large series of patients with rheumatic chorea, one can expect to see emotional, behavioral, and mental aberrations that range from acute emotional lability to overt psychosis. This is well documented. Furthermore, one would be hard put to differentiate the motor component of a complex partial seizure from the wild and variable movements commonly seen in

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