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Case Series: Increased Vulnerability to Obsessive-Compulsive Symptoms With Repeated Episodes of Sydenham Chorea

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ABSTRACT

The association between obsessive-compulsive symptoms (OCS) and Sydenham chorea (SC) supports the hypothesis of a common neuroimmunological dysfunction in basal ganglia associated with group A β-hemolytic streptococcal infection underlying both conditions. Four children with 2 distinct SC episodes were evaluated to assess the course of OCS. All patients developed OCS during their second episodes (3 met criteria for obsessive-compulsive disorder [OCD]), but not in their first episodes (2 developed OCS and met criteria for OCD). These data suggest that the recurrence of SC episodes may result in a cumulative effect, thus increasing the risk of appearance and intensification of OCS.

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This work was supported by Fundação de Amparo à Pesquisa do Estado de São Paulo: grants 96/09046–6 and 98/15247–0 to Dr. Asbahr and grant 95/0194–0 to Dr. Gentil.

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