Diagnostic Dilemma - Pediatric Oncall
Author: Pediatric Oncall
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.
Answers of this discussion
Author :- sree harsha on 04 July 2012.

Author :- nadir brivkani on 05 July 2012.
Answer :- these are features of sydenham`s chorea this pat. needs EEG and cardiac evaluation

Author :- JAIME BIMSTEIN on 06 July 2012.
Answer :- Sydenham Corea, rule out rheumatic fever

Author :- pawan mandviya on 06 July 2012.
Answer :- rheumatic chorea

Author :- amanyameenaly on 07 July 2012.
Answer :- After hospital admission to manage rheumatic chorea lab. work ESR,CRP, AsOT and echo cardiography are most needed. Then starting Haloperdole treatment.And managing heart condition accordingly . Long acting penicillin for life is essential.and periodic echo cardiography should be advised.

Author :- ziadismiel qas on 07 July 2012.
Answer :- this is a case of HUNTGTON CHOREA

Author :- Henrietta Okafor on 08 July 2012.
Answer :- subacute sclerosing pan encephalitis

Author :- Henrietta Okafor on 08 July 2012.
Answer :- rule out past history of measles

Author :- fificash ad on 08 July 2012.
Answer :- ESR ` ASOT and ECHO :- if normal follow up is needed as it may be SLE

Author :- Olof Raskca on 08 July 2012.
Answer :- Anti NMDA-receptor {or associated} encephalitis

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