Chorea gravidarum

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Chorea gravidarum
SpecialtyNeurology, obstetrics Edit this on Wikidata

Chorea gravidarum is a rare

chorea which presents with involuntary abnormal movement, characterized by abrupt, brief, nonrhythmic, nonrepetitive movement of any limb, often associated with nonpatterned facial grimaces. It is a complication of pregnancy which can be associated with eclampsia and its effects upon the basal ganglia. It is not a causal or pathologically distinct entity but a generic term for chorea of any cause starting during pregnancy. It is associated with history of Sydenham's chorea. It mostly occurs in young patients; the average age is 22 years.[2][3]

Recently there has been a decline in incidence which is probably the result of a decline in

antibiotics for streptococcal pharyngitis.[citation needed
]

Pathophysiology

Several pathogenetic mechanisms for chorea gravidarum have been offered, but none have been proven. History of either

estrogens and progesterone may sensitize dopamine receptors (presumably at a striatal level) and induce chorea in individuals who are vulnerable to this complication by virtue of preexisting pathology in the basal ganglia
. The relation to rheumatic fever was strengthened by many studies that showed that women with normal pregnancies before rheumatic fever developed chorea in subsequent pregnancies.
acute rheumatic fever.[2][3]

It has been suggested that use of oral contraceptives is an infrequent cause of chorea. A patient developed this chorea with no definite evidence of previous Sydenham's chorea or recent streptococcal infections, but had anti-basal ganglia

antibodies, suggesting immunological basis for the pathophysiology of this chorea.[6][7]

Diagnosis

Differential diagnoses

Chorea can also be a manifestation of drug toxicity (for example,

meningovascular syphilis, Lyme disease, viral encephalitis, and many others.[citation needed
]

Treatment

Drug treatment is indicated for patients with severe disabling chorea. It is treated with

Valproic acid, chloral hydrate, risperidone, or phenobarbital can also be used.[13]

See also

References

  1. PMID 5742087
    .
  2. ^
    doi:10.1001/archinte.1932.00150100128011
    .
  3. ^
    doi:10.1001/archinte.1932.00150110134008
    .
  4. ^ Black, M (1900). "Two cases of chorea in pregnancy". Glasgow Medical Journal: 441–4.
  5. ^ Matthews, AA (1911). "Chorea complicating pregnancy". Northwest Med. 15: 372.
  6. PMID 14742621
    .
  7. S2CID 7819141
    .
  8. ^ Chorea Gravidarum at eMedicine
  9. PMID 4643046
    .
  10. PMID 472859
    .
  11. PMID 7078886
    .
  12. S2CID 38192455
    .
  13. ^ Chorea Gravidarum~treatment at eMedicine

Further reading

  • Palanivelu, L. M. (2007). "Chorea gravidarum". Journal of Obstetrics & Gynaecology. 27 (3): 310.
    S2CID 119999
    .

External links
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