About rheumatic chorea
What is rheumatic chorea?
Sydenham chorea is a rare neurological disorder characterized by rapid, involuntary, purposeless movements, especially of the face, feet and hands. Additional symptoms may include muscle weakness and emotional or behavioral problems. Sydenham chorea most often affects children and adolescents. Sydenham chorea usually develops following Streptococcal infection and may occur as an isolated finding or as a major complication of acute rheumatic fever. The movement disorder is considered an autoimmune disorder, meaning it occurs when the body's immune system (which normally responds to a foreign substance) mistakenly attacks healthy tissue.
What are the symptoms for rheumatic chorea?
Rheumatic chorea, also known as Sydenham chorea, is an autoimmune disorder. The immune system in the affected person misrecognized basal ganglia cells as hemolytic streptococci. The basal ganglia is a part of the brain that controls and coordinates body movements. Infection with group A and B hemolytic streptococcus strains triggers a hypersensitive humoral response mediated by antibodies against antigens on basal ganglia cells. In recent years, the incidence has reduced due to improved hygienic practices. The disease can recur even after the elimination of infection using antibiotics.
Symptoms
1. Rheumatic chorea is episodic, with the first episode occurring a week to 6 months following the responsible infection.
2. Chorea refers to abnormal movements that characterize the disease. When an incident occurs in children, doctors misdiagnose the abnormal movements and involuntary facial expressions with the instincts and Clumsiness of children.
3. The disease primarily causes a rheumatic Fever that presents as a general fever, Pain in the chest or joints, pink rashes with rings and lines, sore throat, fast heart rate, and fatigue.
4. Motor symptoms affect all the limbs. They include involuntary movements, poor tone, muscular weakness, gait disturbances, loss of motor control, deterioration of handwriting, slurred speech, and facial grimacing.
5. The patients experience difficulty in carrying out basic tasks such as dressing, eating, and simply holding objects.
6. Behavioral problems include attention deficits, hyperactivity, obsession and compulsion, psychosis, irritability, and confusion.
Symptoms
Rapid, involuntary jerking movements,Faulty motor skills in an awakened state,TwItching movements,The muscles of speech affected,Difficulty swallowing
Involuntary jerking motions were noticed in the limbs and face,TwItching movements on the limbs,Impact on swallowing and speech muscles,Irritability,Anxiety,Emotional instability which includes sobbing fits brought on by little events
Conditions
Abrupt involuntary movements,Inability to sustain tongue protrusion or eye closure,Instability in walking and difficulty with handwriting,Irritability, anxiety, emotional instability,Attention deficit,Inability to perform day-to-day tasks,Muscle weakness,Slurred speech (dysarthria),Inflammation of the heart valves in some severe cases
Drugs
Prophylactic penicillin,Symptomatic (antipsychotic and anticonvulsant) medications,Low doses of potent dopamine receptor blocking agents such as haloperidol,Anti-seizure medications
What are the causes for rheumatic chorea?
Rheumatic chorea is known by various other names like Sydenham chorea, chorea minor, St.Vitus Dance, etc.
1. Rheumatic chorea is regarded as the manifestation of Rheumatic fever caused by the bacterium Group A beta-hemolytic streptococcus (GABHS).
2. It is an autoimmune disorder that occurs when the body’s immune system mistakenly reacts against healthy tissue.
3. It is a neurological disorder that occurs most often in children between the ages of 5 and 15 years.
4. Very rarely, the disorder has been reported in children under the age of 5 years or in adults.
5. It is considered an autoimmune disorder, meaning it occurs when the body’s immune system (which usually responds to foreign substances) mistakenly targets part of the body, disrupting its normal function.
Symptoms
Rapid, involuntary jerking movements,Faulty motor skills in an awakened state,Twitching movements,The muscles of speech affected,Difficulty swallowing
Involuntary jerking motions were noticed in the limbs and face,Twitching movements on the limbs,Impact on swallowing and speech muscles,Irritability,Anxiety,Emotional instability which includes sobbing fits brought on by little events
Conditions
Abrupt involuntary movements,Inability to sustain tongue protrusion or eye closure,Instability in walking and difficulty with handwriting,Irritability, anxiety, emotional instability,Attention deficit,Inability to perform day-to-day tasks,Muscle weakness,Slurred speech (dysarthria),Inflammation of the heart valves in some severe cases
Drugs
Prophylactic penicillin,Symptomatic (antipsychotic and anticonvulsant) medications,Low doses of potent dopamine receptor blocking agents such as haloperidol,Anti-seizure medications
What are the treatments for rheumatic chorea?
Rheumatic chorea (RC) is a neurological disorder seen in young children and adolescents. It has been observed to be triggered usually in a person with a history of incompletely treated group A beta-hemolytic streptococcal (GABHS) pharyngitis.
It is an autoimmune disorder that occurs when the body’s immune system mistakenly reacts against its own healthy tissue. In many cases, it is reported to occur in 20–30% of people with acute rheumatic fever.
Accurate and specific treatment for Rheumatic chorea is not there. However, some successful methods of treatment are listed below -
Treatments for Rheumatic chorea
1. A need for a heart evaluation to check for signs of valve disease or endocarditis.
2. Anticonvulsants are drugs that help by stabilizing nerve impulses. They include valproic acid and carbamazepine.
3. During the initial stages, adequate bed rest is advised by the doctors.
4. Valproic acid is generally given under Antiepileptic medications.
5. Doctors prescribed that children take penicillin over the course of the next 10 years to prevent additional manifestations.
Symptoms
Rapid, involuntary jerking movements,Faulty motor skills in an awakened state,Twitching movements,The muscles of speech affected,Difficulty swallowing
Involuntary jerking motions were noticed in the limbs and face,Twitching movements on the limbs,Impact on swallowing and speech muscles,Irritability,Anxiety,Emotional instability which includes sobbing fits brought on by little events
Conditions
Abrupt involuntary movements,Inability to sustain tongue protrusion or eye closure,Instability in walking and difficulty with handwriting,Irritability, anxiety, emotional instability,Attention deficit,Inability to perform day-to-day tasks,Muscle weakness,Slurred speech (dysarthria),Inflammation of the heart valves in some severe cases
Drugs
Prophylactic penicillin,Symptomatic (antipsychotic and anticonvulsant) medications,Low doses of potent dopamine receptor blocking agents such as haloperidol,Anti-seizure medications
What are the risk factors for rheumatic chorea?
Rheumatic chorea or Sydenham chorea is caused by an infection with bacteria called group A streptococcus.
The movement, posture, and speech of the body is controlled by basal ganglia which are a set of structures deep in the brain.
Risk factors:
1. It is considered an autoimmune disorder, meaning it occurs when the body’s immune system (which usually responds to foreign substances) mistakenly targets part of the body, disrupting its normal function.
2. This bacteria reacts with basal ganglia and this leads to various disorders in the affected person.
3. The abnormal movements due to the chorea affect the day-to-day activities such as walking, writing, and talking.
4. Cardiac valve abnormalities
5. Inflammation of the heart (carditis).
6. Patients with a history of rheumatic fever
7. The low and weak immune system
8. Long-term disorders related to motor skills
9. Leaky heart valve (valve regurgitation). Blood flows backwards across the valve.
Symptoms
Rapid, involuntary jerking movements,Faulty motor skills in an awakened state,Twitching movements,The muscles of speech affected,Difficulty swallowing
Involuntary jerking motions were noticed in the limbs and face,Twitching movements on the limbs,Impact on swallowing and speech muscles,Irritability,Anxiety,Emotional instability which includes sobbing fits brought on by little events
Conditions
Abrupt involuntary movements,Inability to sustain tongue protrusion or eye closure,Instability in walking and difficulty with handwriting,Irritability, anxiety, emotional instability,Attention deficit,Inability to perform day-to-day tasks,Muscle weakness,Slurred speech (dysarthria),Inflammation of the heart valves in some severe cases
Drugs
Prophylactic penicillin,Symptomatic (antipsychotic and anticonvulsant) medications,Low doses of potent dopamine receptor blocking agents such as haloperidol,Anti-seizure medications
Is there a cure/medications for rheumatic chorea?
Rheumatic chorea, also called St. Vitus Dance, chorea minor, infectious chorea, or Sydenham chorea is a neurological disorder triggered during childhood as an immune response to (GABHS) Group A beta-hemolytic Streptococcus pyogenes infection. The bacterial infection causes rheumatic fever (RF) and strep throat in children. Following streptococcal infection, it is a movement condition characterized by erratic and uncontrollable movements of muscle groups in various areas of the body.
1. There is no cure and a neurologist is consulted as part of the treatment.
2. They may recommend immunomodulatory therapies, low-dose antipsychotics, antiepileptic drugs, prophylactic penicillin, symptomatic anticonvulsant medications, and immunomodulatory therapy like steroids, and intravenous immunoglobulin (IVIG), and plasma exchange.
3. The condition can be brought on by a reaction between streptococcus bacteria and the basal ganglia, a region of the brain.
4. Deep inside the brain lies a group of structures called the basal ganglia.
5. They support the control of voice, posture, and movement. Sydenham chorea, which most usually affects children between the ages of 5 and 15, is more common in girls than in boys and is most frequently a symptom of rheumatic fever.
6. The condition could occasionally develop as a pregnancy problem.
Symptoms
Rapid, involuntary jerking movements,Faulty motor skills in an awakened state,Twitching movements,The muscles of speech affected,Difficulty swallowing
Involuntary jerking motions were noticed in the limbs and face,Twitching movements on the limbs,Impact on swallowing and speech muscles,Irritability,Anxiety,Emotional instability which includes sobbing fits brought on by little events
Conditions
Abrupt involuntary movements,Inability to sustain tongue protrusion or eye closure,Instability in walking and difficulty with handwriting,Irritability, anxiety, emotional instability,Attention deficit,Inability to perform day-to-day tasks,Muscle weakness,Slurred speech (dysarthria),Inflammation of the heart valves in some severe cases
Drugs
Prophylactic penicillin,Symptomatic (antipsychotic and anticonvulsant) medications,Low doses of potent dopamine receptor blocking agents such as haloperidol,Anti-seizure medications