Motor problems including<unk>  settle within an average of 2–3 months. Recurrence seen in 16–40% of cases. Recurrence is more likely with poor compliance with penicillin prophylaxis. Intramuscular penicillin is given every 2–3 weeks superior to 4 weekly regime, and oral penicillin is also prescribed. Recurrences are sometimes associated with rise in ASO titre or other evidence of new streptococcal infection. There is no obvious clinical parameter that might predict those at risk of recurrence. More likely if failure to remit in initial 6 months, can recur with pregnancy<unk>  gravidorum). Higher recurrence rates seen in longest follow up – can recur up to 10 years after the initial episode, so might be underestimated by series with shorter follow up. Recurrence is usually only<unk> , even if the original case was associated with rheumatic fever. There are two total reports of heart disease worsening after recurrence of<unk> . The Thailand study also had 2 cases where carditis, which had improved after initial diagnosis, came back again. Some suggest that recurrent<unk>  is a different disease altogether. 10% reported long term tremor in one study (10 years follow up). Long term neuropsychiatric difficulties are increasingly recognized (49 studies so far, especially obsessive-compulsive disorder but also attention-deficit hyperactivity disorder, affective disorders, tic disorders, executive function disturbances, psychotic features, and language impairment). Heart involvement improves in about a third of cases (whether silent or not).
Sydenham's chorea
Huntington's disease
Benign hereditary chorea
Parkinson-plus syndrome
Wernicke–Korsakoff syndrome
Huntington's disease-like syndrome
X-linked dystonia parkinsonism
Stratton Parker syndrome