INCREASED STRIATAL GLUCOSE CONSUMPTION IN SYDENHAM CHOREA

Positron emission tomography and F-18-fluorodeoxyglucose were used to measure the regional cerebral glucose consumption in a 15-year-old cho reatic girl with classical Sydenham's chorea shortly after the onset o f hyperkinetic movements and 5 months later after chorea had resolved and in a 74-year-old hemichoreatic woman with long-standing hyperkines ia as a residuum of Sydenham's chorea in adolescence. Whereas cerebell ar, thalamic, and cortical glucose consumption was within normal limit s in both patients, lentiform and caudate glucose consumption was sign ificantly increased in both hemispheres of the 15-year-old patient and in the hemisphere contralateral to the chorea in the 74-year-old pati ent. In the younger patient, striatal glucose consumption returned to normal after her hyperkinesia had disappeared with antibiotic therapy. The observation of an increase in striatal glucose consumption in Syd enham's chorea, in contrast to the decrease of this variable encounter ed in the vast majority of other choreatic disorders, leads to questio ning the pathophysiology of chorea in humans and suggests the use of e mission tomographic measurement of variables related to cerebral energ y metabolism for differential diagnosis in choreatic disorders.