Saint Vitus and Sydenham’s chorea

Tuesday, 15 June (2010), is the feast day of Saint Vitus, a Christian martyr who is the patron saint of epilepsy, dancing and Bohemia.

Legend has it that Vitus was converted to Christianity at the age of 12 by his tutor, St Modestus, and his nurse, St Crescentia, against the wishes of his pagan father, who had them all arrested.

The three fled from Sicily to Rome, where Vitus freed the son of Emperor Diocletian from an evil spirit. His cure was attributed to sorcery and the trio were subjected to various tortures, including being thrown to the lions, from which they emerged unscathed. They eventually succumbed to boiling in oil around 303.

The relic of the bones of one hand of St Vitus were given to the Duke of Bohemia by King Henry I of Germany in 925. This relic is now a sacred treasure at St Vitus Cathedral in Prague.

St Vitus is one of the 14 Holy Helpers, who give help in times of trouble and are particularly venerated in France and Germany. His intercession was said to cure epilepsy during the Middle Ages.

During an outbreak of dancing mania that broke out in mainland Europe between the 14th and 18th centuries, people often prayed to St Vitus for aid and he soon became the dancers’ patron saint. The outbreak involved groups of people, often thousands at a time, who would dance uncontrollably and bizarrely through the streets.

The cause of this outbreak remains uncertain, although it is likely to be down to mass hysteria, as in the Tanganyika laughter epidemic (see Prospector, PJ, 6 February 2010, p142).

St Vitus’s dance should not be confused with manic dancing, but is a term used for Sydenham’s chorea, a condition that causes rapid, irregular involuntary movements of the arms, legs, trunk and facial muscles.

Sydenham’s chorea is a childhood neurological disorder resulting from infection with Group A beta-haemolytic streptococcus, the bacterium that causes rheumatic fever. The movements are caused by an autoimmune reaction to the bacterium that interferes with normal functioning of the basal ganglia. The condition is rare in Europe and North America but still occurs in developing countries.

There is no specific treatment for Sydenham’s chorea, but for those with the mildest form, bed rest during periods of active movement is sufficient. Sedatives such as benzodiazepines may be needed for more serious cases, and antiepileptics such as valproic acid may also be used. Most children recover completely, although a small number continue to suffer from disabling, persistent chorea.