In William Shakespeare’s classic Romeo and Juliet, Juliet ponders, “What’s in a name?” I recently began pondering that question myself as it relates to neurologic conditions. Historically, symptoms and disorders have been named after the researcher who first described them (Dr. Alois Alzheimer, for example, for Alzheimer’s disease), the people who brought them national attention (Lou Gehrig for amyotrophic lateral sclerosis), the place where they were first discovered (Lyme disease for the deer ticks found in Lyme, CT), and even animals (mad cow disease for Creutzfeldt-Jakob disease). The trend today is to call diseases by names that reflect their biology, although many of these older naming conventions remain.

This is the first post in a series of articles in which we’ll explore the history behind the naming of neurologic illnesses to learn how and why the names came to be. If they were changed, we’ll find out why and examine how these changes affect us as a community.

We start with a disease originally known as St. Vitus dance but is now called Sydenham chorea. This childhood movement disorder is an inflammatory response to strep throat or rheumatic fever and is characterized by rapid, involuntary, irregular movements of all muscles except those that move the eyes. The condition was named for St. Vitus, the patron saint of dancers, who was born in Sicily in 209 AD and died 13 years later. Since 836 A.D., the saint has been commemorated in Germany where celebrants dance jubilantly. It is likely that the irregular movements of the children with this condition resembled those dancers.

Current Name: Sydenham Chorea

In the 1600s, Dr. Thomas Sydenham—an English physician and author of Observationes Medicae, a landmark clinical textbook—changed the name of the disease to chorea to reflect its physiology. The name derives from the Greek word khoreia, which means dancing in unison, or khoros, the Greek equivalent of chorus, according to the Oxford English Dictionary. The chorea associated with strep throat and rheumatic fever became known as Sydenham chorea. Chorea, in general, is defined as a “state of excessive, spontaneous movements, irregularly timed, non-repetitive, randomly distributed, and abrupt in character” by the Committee on Classification of the World Federation of Neurology and can be caused by stroke, trauma, and inherited conditions such as Huntington’s disease. The symptom can be minor (restlessness or fidgeting) or severe (dance-like movements while walking or violent thrashing motions).

Disease Basics

Sydenham chorea may occur in children after a strep throat infection or rheumatic fever. It can cause jerky, uncoordinated movements in the limbs, trunk, and face. Treatment includes consultation with a neurologist, who may prescribe penicillin or low-dose antipsychotic or antiseizure medications or immunomodulatory therapies. Symptoms usually resolve within three to six weeks. For children who get recurring strep throat, antibiotics are recommended.