Sydenham's chorea, is a childhood disease often associated with rheumatic fever which is characterized by involuntary, purposeless contractions of the muscles of the trunk and extremities; anxiety; and impaired memory, and sometimes speech. It commonly occurs between the ages of five and fifteen, and is seen more often in girls than in boys.

In general terms, this condition is regarded as an inflammatory complication of group A-hemolytic streptococcal infection, which causes rheumatic fever (see Diagnostic Code: 6309 Rheumatic fever). Up to ten percent of patients with rheumatic fever develop the condition. It is believed that the illness is probably immune-mediated, causing a surge of inflammatory response and tissue injury.

The onset of symptoms may occur up to twelve months after a streptococcal infection. Symptoms may occur after other manifestations and laboratory results return to normal. The symptoms transpire frequently along with carditis. The condition manifests with rapid, purposeless, nonrepetitive, involuntary movements that disappear with sleep, and may involve all muscles with the exception of the ocular muscles. The movements are sudden with impaired movement coordination. Grimacing of the facial muscles is not uncommon. Patients with mild cases may experience difficulties in dressing or feeding themselves, and may appear to be clumsy.

This condition has no distinct laboratory indicators other then occasional residual evidence of a previous streptococcal infection. Diagnosis is most often based on actual observation and from data or facts, e.g., the occurrence of the irregular involuntary movements that indicate the disorder.

Severe cases may require sedation and safety measures to avoid self-injury from flailing arms or legs. No drug has shown consistent effectiveness. In extreme cases, antipsychotic drugs are given to moderate the movements.

The condition is self-limiting. It may end within three months, but occasionally lasts six to twelve months.

•  Dependent upon relative degree of sensory manifestation or motor loss.

• May be entitled to special monthly compensation where the Veteran has a single service-connected disability rated as 100% with additional service-connected disability or disabilities independently ratable at 60% or more, which are separate and distinct from the 100% service-connected disability and involves different anatomical segments or bodily systems. See  38 CFR 3.350(i)(1) – Special Monthly Compensation (SMC).

• Consider rheumatic etiology and complications.