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Child has abnormal movements of hands and legs. Earlier treated for rheumatic fever. Problem?

year old girl from the cardiology ward developed acute onset of abnormal movements involving her hands and legs. This affected her gait and she walked in a funny way. The movements seemed purpose less and random. They looked as if she was dancing in a relative slowness. Her mother mentioned disappearance of movement during sleep. There were no dysphagia or visual symptoms. She is treated for rheumatic fever for 7 days now and the doctor is happy about her heart . QUESTIONS : 1- What is the likely problem encountered in this young girl? 2- What part of the brain is affected? 3- What is the underlying pathological process? 4- When do you expect her to improve?
Asked On : Thu, 24 Jan 2013
Answers:  2 Views:  31
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Pediatrician 's  Response
Thank you for your query.
Your questions are very well put.
These are all symptoms of rheumatic fever.
These quasipurposive movements are known as chorea.
The basal ganglia are affected.
The underlying process is an autoimmune activity against different body tissues.
She will improve but will require life time penicillin injections.
Hope this answers your query.If you have any other queries kindly direct them to me.Wishing your child a speedy recovery.Have a nice day.
Answered: Fri, 25 Jan 2013
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Pediatrician Dr. Synthyia Bhagat's  Response
Thanks for your query.
1)she is having Syndenhem chorea which are these purposeless random movements,present at rest and usually cease during sleep is mostly seen in girls.
2)Basal ganglia is the part of brain which is affected.
3)There is imbalance among dopaminergic system,cholinergic system and inhibitory GABA system
4)Chorea is usually self limited but sometimes anticonvulsants are needed.They need prophylaxis against streptococcal infection till 18 years of age..

Hope i have answered your question
God bless,
Answered: Fri, 25 Jan 2013
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