All are true regarding rheumatic chorea except: (Repeat)
Ans: B (May cause Neurologic sequlae) Ref: Harrison's Principles of Internal Medicine, 18ed & Nelson's Textbook of Pediatrics. 19th EditionExplanation:CHOREAOccurs in 10-15% ol patientsPresents as an isolated, subtle, neurologic behavior disorderSymptoms includeEmotional labilityIncoordinationPoor school performanceUncontrollable movementsFacial grimacingSymptoms exacerbated by stress and disappearing with sleepThe latent period from acute GAS infection to chorea is usually longer than for arthritis or carditis and can be months.Commonly occurs in the absence of other manifestationsProlonged latent period after group A streptococcal infectionFound mainly in females.Onset can be insidious, with symptoms being present for several months before recognition.Clinical maneuvers to elicit features of chorea include:- Demonstration of milkmaid's grip (irregular contractions of the muscles of the hands while squeezing the examiner's fingers).- Spooning and pronation of the hands w hen the patient's arms are extended.- Wormian darting movements of the tongue upon protrusion.- Examination of handwriting to evaluate fine motor movements.Chorea does not cause permanent neurologic sequelae.Chorea eventually resolves completely, usually within 6 weeks.
Absent in sleep
May cause Neurologic sequelae
Lasts for 4 to 10 wks
Common in girls
C.N.S.