Treatment of Chorea in Childhood

Yılmaz, Sanem; Mink, Jonathan W.

doi:10.1016/j.pediatrneurol.2019.08.013

Cited by 20 publications

(15 citation statements)

References 118 publications

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“…Hemichorea can present with weakness; in one of our patients, this was the only complaint. Neuroimaging may be necessary when hemichorea is evident as structural basal ganglia etiologies like stroke, moyamoya disease, and vascular malformations can cause hemichorea (18,19) . Five of our chorea patients underwent cranial MRI with normal results.…”

Section: Discussionmentioning

confidence: 99%

“…Antiphospholipid antibody syndrome is one of the differential diagnoses of Sydenham chorea (18) . This chorea is most commonly unilateral, appears in a single episode, and regresses spontaneously or with medication (20) .…”

Section: Discussionmentioning

confidence: 99%

“…The treatment of chorea falls into three categories: terminating exposure to the causative agent, symptomatic treatment, and treatment of the underlying etiology (18) . Although the pathophysiology of Sydenham chorea is still unclear, the crossreactivity of streptococcal antibodies with the basal ganglia and the brain cross-reactive epitopes of streptococcal M proteins are blamed in patients with Sydenham chorea (24,25) .…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of Patients with an Initial Diagnosis of Chorea: Sydenham Chorea and Differential Diagnoses

Uzunhan¹,

İrdem²

2020

BMJ

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Objective: Our aim is to evaluate patients being referred with an initial diagnosis of chorea according to their clinical, laboratory features and final diagnoses while emphasizing cardiological findings of patients with Sydenham chorea. Method: Children aged 4-18 years who were referred to Okmeydanı Research and Training Hospital Pediatric Neurology department with an initial diagnosis of acute, subacute chorea between January 2017-January 2020 were retrospectively included. Chronic chorea and diseases associated with chronic chorea were excluded from the study. Data concerning clinical, laboratory features, cardiological findings, etiologies, treatments, recurrence rates and follow-ups of patients were recorded. Descriptive statistical analysis were performed using SPSS 21.0. Results: Fifteen patients has been referred with the initial diagnosis of chorea. Mean age of the patients was 11.5±2.2 years. Ten (67%) patients were females, 5 (33%) patients were male. After admission, 8 (54%) patients were diagnosed with Sydenham chorea, and 2 (13%) patients with recurrent Sydenham chorea. During physical examination, 5 (33%) patients did not have chorea, and 3 cases had tic disorder. Out of 8 patients with new diagnosis of Sydenham chorea, 3 (37.5%) patients had subclinical carditis, and 5 (62.5%) patients clinical carditis. Chorea had been treated with one of haloperidol/biperiden, valproic acid and prednisolon options. The treatment of 6 patients attending regular follow-up visits was stopped 2-6 months later. Chorea of two patients recurred during our follow-up, and one of our newly diagnosed Sydenham chorea patients had been recognized as antiphospholipid antibody syndrome after recurrence. Conclusion: Sydenham chorea is the most common cause of acquired chorea in childhood. Most of the time it is self limiting. Differential diagnosis of chorea must be kept in mind especially when there is a recurrence.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Evaluation of Patients with an Initial Diagnosis of Chorea: Sydenham Chorea and Differential Diagnoses

Uzunhan¹,

İrdem²

2020

BMJ

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“…El tratamiento farmacológico tiene como objetivos: la disminución de la sintomatología y tratar el agente etiológico de la CG. El manejo sintomático se basa en tres grupos de fármacos: los antipsicóticos, las benzodiacepinas y los agentes que disminuyen la dopamina; se debe complementar con el tratamiento etiológico (6). Aunque en general el pronóstico de la CG es bueno, en algunos casos severos de CG puede llegar a presentarse hipertermia y la muerte (7).…”

Section: Introductionunclassified

Corea Gravídica: reporte de caso y revisión de la literatura

Rengifo-Quintero

Beltrán-Avendaño

2019

Rev. Colomb. Obstet. Ginecol.

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Objetivos: presentar un caso de corea gravídica y hacer una revisión sistemática de la literatura publicada sobre el tratamiento y pronóstico materno-fetal de la entidad. Materiales y métodos: se presenta el caso de una paciente de 16 años, primigesta, que ingresa a un hospital público de tercer nivel de complejidad, con 8 semanas de gestación, con clínica de 3 días de evolución caracterizada por movimientos involuntarios de la cabeza y las extremidades, con hiperreflexia en miembro inferior derecho. Antecedente de Corea de Sydenham. Se da tratamiento con antisicóticos y benzodiacepinas para la sintomatología y etiológico con penicilina benzatínica y control del cuadro a las 14 semanas. Suspendió el tratamiento a las 35 semanas. Parto normal a las 39 semanas. Se realizó una búsqueda en la base de datos de Medline vía PubMed, UptoDate, Medscape y Google Académico empleando los términos: “Pregnancy” and “Chorea Gravidarum”. La búsqueda se limitó a reportes y series de casos o artículos de revisión, desde el año 2000 al 2019. Resultados: se encontraron siete reportes de casos y una revisión de tema. El tratamiento se realizó con haloperidol benzodiacepinas y clorpromacina en cuatro de los siete casos. En uno de los dos casos con antecedentes de corea de Sydenham se utilizó penicilina. El pronóstico materno-fetal fue bueno en seis de siete casos, en un caso hubo restricción de crecimiento intrauterino. Conclusión: el tratamiento de la corea gestacional principalmente es expectante y su finalidad es disminuir la sintomatología, el pronóstico materno-fetal es bueno.

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“…Carbamazepine (CBZ), valproic acid (VPA), benzodiazepines, and levetiracetam (LEV) are the main AEDs in SC. 1 Despite sharing similar action mechanisms and having fewer potential side effects, oxcarbazepine (OXC) has not been subject to any study in SC in the literature to the best of our knowledge. However, its effectiveness has been shown in paroxysmal kinesigenic dyskinesia (PKD), which is another chorea-related movement disorder.…”

mentioning

confidence: 99%