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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There was also no history of any neuroleptic drug or metocloperamide intake. The patient herself complained of excessive salivation and she denied any movement disturbance. She was discharged of the hospital four days later, having only abnormal movement in the right hand. Pregnancy is the time of gravidaruum hormonal milieu, it can lower the threshold for chorea and emotional outburst can precipitate it.
Gravidaru disease Pantothenate kinase-associated neurodegeneration Ramsay Hunt syndrome Huntington’s disease Striatonigral degeneration Chodea syndrome Systemic lupus erythematosus Lyme disease Torticollis Multiple system atrophy Tourette syndrome and other tic disorders Neuroacanthocytosis Viral encephalitis Neuronal ceroid lipofuscinosis Wilson’s disease Olivopontocerebellar atrophy Familial paroxysmal choreoathetosis Benign hereditary chorea .
It is not an causal or pathologically distinct entity but a generic term for chorea of any cause starting during pregnancy. Power and reflexes were normal in all four limbs. Sensory system and all cranial nerve examination were normal with flexor plantar response. She was also on a regular follow-up with a psychiatrist for counselling. Acute fatty liver of pregnancy Gestational diabetes Hepatitis E Hyperemesis gravidarum Intrahepatic cholestasis of pregnancy.
The involuntary movements in her tongue and arms were neglected as the attendants took her to a local priest thinking it as an evil spirit in the hills. Group A streptococcal infection induces antibodies against the host neural tissues by a phenomenon called molecular mimicry.
The patient was fidgety. Create a personal account to register for email alerts with links chorae free full-text articles. The patient was constantly trying to cover her head with her cloth each time she was having choric movements.
Encephalomyelitis Acute disseminated Myalgic Meningoencephalitis. While the family members feel it to be a spirit haunting her, we try to establish the medical diagnosis of the present condition. This finding, as well as the persistence of the movement disorder, uncommon in chorea gravidarum, 2 suggests that the chorea of the patient was related to some other cause, perhaps a stroke.
From Wikipedia, the free encyclopedia. The first and second trimesters of her pregnancy had been uneventful. This is a case of chorea gravidarum in third trimester of pregnancy with a normal fetal outcome.
BSL compiled the case report and submitted it online. Discussion Chorea is an involuntary abnormal movement characterised by abrupt, brief, non-rhythmic and non-repetitive movement of any limb, often associated with non-patterned facial grimaces.
[Chorea gravidarum. A case report].
Several pathogenetic mechanisms for chorea gravidarum have been offered, but none have been proven. Laboratory studies were as shown in table 1.
Post-streptococcal autoimmune disorders of the central nervous system. Gestational thrombocytopenia Pregnancy-induced hypercoagulability. Not commissioned; externally peer reviewed. Copyright American Medical Association.
Another condition associated with anti-basal ganglia antibodies”. Get free access to newly published articles Create a personal account or sign in to: Slit-lamp examination of the eyes was normal.
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.
History of either rheumatic fever or chorea is suspected: