Chorea is an abnormal involuntary movement disorder, one of a group of neurological disorders called dyskinesias, which are caused by
overactivity of the neurotransmitter dopamine
in the areas of the brain that control movement.
Why do kids with chorea have rheumatic fever?
Sydenham chorea (SC) is a
neurological disorder of childhood resulting from infection via Group A beta-hemolytic streptococcus (GABHS)
, the bacterium that causes rheumatic fever. SC is characterized by rapid, irregular, and aimless involuntary movements of the arms and legs, trunk, and facial muscles.
What causes chorea in rheumatic fever?
Sydenham chorea
What is the cause of St Vitus dance?
Sydenham chorea, also known as St. Vitus dance, is a
neuropsychiatric manifestation of rheumatic fever
with an incidence varying from 5 to 35%. It may occur alone or concomitantly with other manifestations of rheumatic fever.
What is the most common cause of chorea?
The most common causes of chorea are:
Huntington’s disease
: People inherit this genetic disorder from their parents. In addition to chorea, it causes changes in personality and problems with speech, coordination, and memory. Symptoms of Huntington’s disease get worse over time (usually over 10 to 20 years).
Does chorea go away?
The movements of Sydenham’s chorea are often not treated because the symptoms are so mild and
the condition will most likely go away on its own after a few months
. More severe cases, where the movements interfere with function, may be treated with medications.
Is chorea a symptom of Parkinson’s disease?
Chorea is a
common symptom of Huntington’s disease
and other less-common diseases. Chorea is also frequently observed in patients with Parkinson’s disease taking a medication called levodopa. In this case, it is referred to as “dyskinesias.”
Who is at high risk for rheumatic fever?
Rheumatic fever most often affects
children who are between 5 and 15 years old
, though it can develop in younger children and adults. Although strep throat is common, rheumatic fever is rare in the United States and other developed countries. However, rheumatic fever remains common in many developing nations.
How do you treat chorea?
Atypical neuroleptics include
risperidone
, olanzapine, clozapine, and quetiapine. Dopamine-depleting agents (eg, reserpine, tetrabenazine, deutetrabenazine), represent another option in the treatment of chorea. GABAergic drugs, such as clonazepam, gabapentin, and valproate, can be used as adjunctive therapy.
How is rheumatic chorea treated?
Suggested treatments of chorea in SC include
prophylactic penicillin, symptomatic (antipsychotic and anticonvulsant) medications
, and immunomodulatory therapy (steroids, intravenous immunoglobulin (IVIG), and plasma exchange).
How do you treat Sydenham’s chorea?
There is no specific treatment for Sydenham’s chorea
and symptoms usually resolve themselves in approximately 3 to 6 months. Bed rest, sedatives and medication to control movements may be prescribed. Penicillin prophylaxis may also be prescribed to avoid further streptococcal infection.
Is rheumatic chorea hereditary?
Genetic causes: Benign hereditary chorea starts in childhood and is a
non-progressive chorea
. Inheritance is usually autosomal dominant, although rare cases of autosomal-recessive and X-linked inheritance have been reported.
What is milkmaid grip?
A sign of generalised muscle weakness and inability to maintain tetanic muscle contraction; the subjects, when asked to squeeze the examiner’s fingers, do so by a ‘milking’ motion of contraction and relaxation, a finding typical of Sydenham’s chorea, one of the Jones’ major criteria for diagnosing rheumatic fever.
Can anxiety cause chorea?
When mild, chorea can be difficult to differentiate from restlessness. When chorea is proximal and of large amplitude, it is called ballism.
Chorea is usually worsened by anxiety and stress
and subsides during sleep. Most patients attempt to disguise chorea by incorporating it into a purposeful activity.
How do you get chorea?
- AIDS.
- genetic conditions, such as Huntington’s disease.
- immune conditions, such as systemic lupus erythematosus.
- infection-related conditions, such as Sydenham’s chorea.
- medications, including levodopa and neuroleptics.
- metabolic or endocrine disorders, including hypoglycemia.
What does mild chorea look like?
It is characterized by
brief, abrupt, irregular, unpredictable, non-stereotyped movements
. In milder cases, chorea may appear purposeful. The patient often appears fidgety and clumsy. Overall, chorea can affect various body parts, and interfere with speech, swallowing, posture and gait, and disappears in sleep.
