A 24 year old right handed Pakistani woman who was eight weeks’ pregnant presented with a two day history of involuntary movements of her left arm, hand. According to Willson and Preece, the first description of chorea with onset during pregnancy (chorea gravidarum) was made by Horstius in The English. A pregnant woman, in her early 20s, presents with chorea following an emotional outburst. While the family members feel it to be a spirit.
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It has been suggested that use of oral contraceptives is an infrequent cause of chorea. Focal Generalised Status epilepticus Myoclonic epilepsy. With the declining incidence of rheumatic fever, chorea underlying rheumatic heart disease has become a rarity in the developed world. Retrieved from ” https: Pregnancy is the time of changing hormonal milieu, it can lower the threshold for chorea and emotional outburst can precipitate it.
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Gestational pemphigoid Impetigo herpetiformis Intrahepatic cholestasis of pregnancy Linea nigra Prurigo gestationis Pruritic folliculitis of pregnancy Pruritic urticarial papules and plaques of pregnancy PUPPP Striae gravidarum. Her symptoms had subsided after taking some antibiotics and analgesics from a local health centre.
Chorea gravidarum is an uncommon condition characterized by involuntary movements, speaking alterations and in the affective status during first trimester pregnancy, the incidence is 1 by each pregnancies, it is self limiting and resolves when the pregnancy ends, most of the cases are idiopathic and the rest is associated to the antiphospholipid syndrome, rheumatic fever, thyrotoxicosis, systemic lupus erythematosus, syphilis, Huntington disease or induced by drugs.
Power and reflexes were normal in all four limbs. Though the exact aetiology remains unknown, prompt diagnosis and treatment reduces maternal morbidity and prevents any complication.
Case Report: Chorea gravidarum: a rarity in West still haunts pregnant women in the East
There was also no history of any neuroleptic drug or metocloperamide intake. However, the scenario is different gravidafum developing countries grzvidarum India where rheumatic fever still occurs frequently.
The differentials which were considered on history and examination were chorea gravidarum, systemic lupus erythematosus, primary anti-phospholipid antibodies, viral encephalitis, Huntington disease and Wilson disease. Extrapyramidal and movement disorders Pathology of pregnancy, childbirth and the puerperium.
Several pathogenetic mechanisms for chorea gravidarum have been offered, but none have been proven.
Sensory system and all cranial nerve chotea were normal with flexor plantar response. Create a free personal account to make a comment, download free article PDFs, sign up for alerts and more.
Chorea can also be a manifestation of drug toxicity for example, anticonvulsantsantiparkinson agentsneurolepticssteroidsand estrogenor a result of an infectious disease such as meningovascular syphilisLyme diseaseviral encephalitisand many others.
Tone was slightly reduced in upper limbs than lower limbs.
It mostly occurs in young patients; the average age is 22 years. This finding, as well as the persistence of the movement disorder, uncommon in chorea gravidarum, 2 suggests that the chorea grsvidarum the patient was related to some other cause, perhaps a stroke. AS is the obstetrician who carefully assisted in the patient delivering a healthy fetus. Views Read Edit View history.
Patients with Sydenham’s chorea are at risk for the development of rheumatic carditis particularly mitral stenosis and to prevent this, a regimen of daily penicillin prophylaxis should be instituted and maintained.
In the 19th century, several authors 3 – 6 published important studies on chorea gravidarum that, along with the article by Willson and Preece, 1 helped to forge the contemporary way of viewing this peculiar form of chorea. Pathology of pregnancychildbirth and the puerperium O— Another condition associated with anti-basal ganglia antibodies”. Encephalitis Viral encephalitis Herpesviral encephalitis Limbic encephalitis Encephalitis lethargica Cavernous sinus thrombosis Brain abscess Amoebic.
Background Chorea gravidarum is a rare movement disorder of pregnancy. She had four normal pregnancies more after, being the last the 10th of February of Create a free personal account to download free article PDFs, sign up for alerts, and more.
There was no family history of any neurological disease. The Journal of Pediatrics. While the family members feel it to be a spirit haunting her, we try to establish the medical diagnosis of the present condition. Purchase access Subscribe to JN Learning for one year. Copyright American Medical Association. Chorea gravidarum is considered a syndrome rather than a specific disease entity.
She had no antenatal health check-ups chorfa this pregnancy. Abstract A pregnant woman, in her early 20s, presents with chorea following an emotional outburst. Published online Jun From Wikipedia, the free encyclopedia.