Chorea

SYDENHAM'S CHOREA

Acute onset. Associated with streptococcal infection. Remits in weeks. Pathology: Necrotising arteritis in thalamus, caudate nucleus and putamen. Diagnosis is confirmed by elevated ESR and ASO (antistreptolysin) titre. Treatment: Sedation, phenothiazines.

The condition may become recurrent - during pregnancy, intercurrent infection.

CHOREA GRAVIDARUM

Acute onset in pregnancy, usually the first trimester.

Restricted to face or generalised. Perhaps caused by reactivation of Sydenham's chorea. Pathology: Unknown. Treatment: Haloperidol. Benign Chorea

Dominant inheritance with incomplete penetration. Onset in childhood

The movements are mild, occasionally aggravated by physical exercise and only rarely progressive.

... or sustained inversion of the foot.

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