Diagnostic Dilemma - Pediatric Oncall
Chorea
Author: Pediatric Oncall
Question
A 10 years old boy presented with purposeless involuntary movements of right side of body for past 2 days which disappeared in sleep and accompanied by emotional liability. There is no fever, jaundice, drug ingestion or any other illness in past. On examination he has bilateral choreoathetosis {right side more than the left} with positive milk maid’s sign, Jack in the box sign and pronator sign. Other systems are normal.
Expert Opinion :
Thanks for wonderful answers. Apart from rheumatic chorea, we will have to rule out wilson’s disease, hemosiderosis, HIV, basal ganglia calcifications, infarct, moya moya disease, Huntington’s chorea. We need to do an MRI brain, ASLO, HIV, and 24 hours urine for copper.
Answer Discussion :
S
Shivani Randev
Seems to be Rheumatic chorea. Essential criteria may not be found but investigate for other major and minor criteria. Treatment is haloreidol.
4 years ago
R
Radha Kumar
Rheumatic chorea
4 years ago
S
SAJJAD saneeq
most common cause rheumatic chorea.
IEM,

4 years ago
A
anusha doraiswamy
Rheumatic chorea` ECG, Echo, Sodium valproate or haloperidol, ANA, KF ring, MRI Brain
5 years ago
S
Seturam Pandurangi
ASLO titre for strep` EKG
5 years ago
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