Sydenham chorea (Rheumatic Chorea)
Most common course of acquired chorea of child hood and is the sole neurological manifestation of rheumatic fever.
More common in female. Q
Three major features of sydenham chorea include chorea, hypotonia, and emotional lability.
These are rapid, jerky movement; they are increased by stress and disappear during sleep.
Following features also present:
- The child relaxes hand grip on and off as if he is milking a cow (milk maid grip)
- When the hand is outstretched above the head, forearms tends to pronate
- When hands are stretched forwards, the patient flexes the wrist and hyper extends the fingers
- The child cannot maintain the tongue in protruded position (darting tongue)
- The knee reflex may show a sustained contraction resulting in a hung-up reflex.
ASLO titer may not be elevated because onset of chorea is late.