The following is a case report of a patient with Sydenham's chorea who later developed schizophrenia. Autopsy examination of this patient revealed mineral deposits in the basal ganglia. The deposition of minerals, especially iron, within subcortical brain structures has been associated with dopaminergic abnormalities, schizophreniform symptoms, and abnormal movement disorders. The psychosis these patients experience is sometimes resistant to treatment with traditional neuroleptics. A CT or MRI scan may prove useful in screening those patients with Sydenham's chorea that develop psychotic symptoms.