“Saint Vitus Dance” is a historical term for a medical condition that has been better understood and reclassified over centuries. This article clarifies the contemporary medical understanding of what was once known as Saint Vitus Dance, exploring its origins and modern identification.
Origins of Saint Vitus Dance
The historical term “Saint Vitus Dance” emerged from dancing manias that swept across Europe between the 14th and 17th centuries. These episodes involved groups engaging in compulsive, prolonged dancing, often to exhaustion. During the Middle Ages, these outbreaks were frequently perceived as a spiritual affliction or possession, rather than a physical illness.
The name linked to Saint Vitus originated because individuals with these involuntary movements were often taken to chapels dedicated to him, believing he possessed curative powers. This practice eventually became intertwined with the nervous disease, leading to the enduring association of the saint’s name with the condition.
Modern Medical Identification
In contemporary medical practice, the historical “Saint Vitus Dance” is now identified as Sydenham’s chorea. This condition is recognized as a neurological disorder characterized by involuntary, rapid, and uncoordinated movements. It is understood to be a manifestation of acute rheumatic fever, which itself is a complication arising from an untreated or inadequately treated infection by Group A beta-hemolytic Streptococcus, the bacteria responsible for strep throat. This connection highlights an autoimmune process where the body’s immune system, in responding to the streptococcal infection, mistakenly targets parts of the brain, leading to the neurological symptoms.
Recognizing Sydenham’s Chorea
Sydenham’s chorea presents with characteristic involuntary movements that resemble dancing. These movements are typically rapid, jerky, and non-rhythmic, affecting various parts of the body including the face, hands, feet, and trunk. For instance, individuals might exhibit grimacing. The fingers may move in a manner akin to playing a piano, and the legs can suddenly give way or flick out, leading to an irregular gait that might appear like skipping.
The involuntary movements can significantly interfere with daily activities such as walking, writing, and speaking. Patients may struggle to maintain a steady hand grip, sometimes demonstrating a “milkmaid sign” where their grip alternately tightens and loosens. Difficulty in keeping the tongue protruded, known as a “darting tongue sign,” can also be observed. Beyond motor symptoms, Sydenham’s chorea can also affect emotional and behavioral well-being, leading to mood swings, anxiety, irritability, and even obsessive-compulsive behaviors.
Addressing the Condition
Sydenham’s chorea is primarily an autoimmune disorder that develops as a post-streptococcal complication, specifically linked to acute rheumatic fever. The immune system’s antibodies, generated to fight the streptococcal infection, mistakenly attack certain areas of the brain, particularly the basal ganglia, which are involved in movement control. Symptoms can emerge weeks to months after the initial streptococcal infection, even if the infection itself was mild or went unnoticed.
Diagnosis relies on observing the characteristic clinical presentation of involuntary movements and assessing the patient’s medical history for a recent streptococcal infection or rheumatic fever. Blood tests to detect streptococcal antibodies can support the diagnosis.
Treatment for Sydenham’s chorea typically involves a two-pronged approach. Antibiotics are administered to eradicate remaining streptococcal bacteria and prevent future infections, reducing recurrence risk and potential cardiac complications. To manage the choreic movements, medications like sedatives or anticonvulsants may be prescribed. The condition is often self-limiting, with symptoms generally improving within months, though some individuals may experience recurrent episodes. Long-term antibiotic prophylaxis is sometimes recommended to prevent further rheumatic fever attacks and associated complications.