A 24 year old right handed Pakistani woman who was eight weeks’ pregnant presented with a two day history of involuntary movements of her left arm, hand. According to Willson and Preece, the first description of chorea with onset during pregnancy (chorea gravidarum) was made by Horstius in The English. A pregnant woman, in her early 20s, presents with chorea following an emotional outburst. While the family members feel it to be a spirit.
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Chorea gravidarum – Wikipedia
The differentials which were considered on history and examination were chorea gravidarum, systemic lupus erythematosus, primary anti-phospholipid antibodies, viral encephalitis, Huntington disease and Wilson disease. She had choreioathetoid, purposeless, irregular and jerky movements bilaterally in her upper limbs.
Breastfeeding difficulties Low milk supply Cracked nipples Breast engorgement Childbirth-related posttraumatic stress disorder Diastasis symphysis pubis Postpartum vravidarum Peripartum cardiomyopathy Postpartum depression Postpartum psychosis Postpartum thyroiditis Puerperal fever Puerperal mastitis. It mostly cchorea in young patients; the average age is 22 years. A pregnant woman, in her early 20s, presents with chorea following an emotional outburst.
Chorea gravidarum is a rare  type of chorea which presents with involuntary abnormal movement, characterized by abrupt, brief, nonrhythmic, nonrepetitive movement of any limb, often associated with nonpatterned facial grimaces.
The dopamine antagonists as the haloperidol and the chlorpromazine are useful to control the symptoms and are safe at lower doses. However, isolated cases still occur in the developing countries and obstetricians need to be aware of this rare manifestation. The first and second trimesters of her pregnancy had been uneventful. Laboratory investigations did not reveal anything interesting. Drug treatment is indicated for patients with severe disabling chorea.
Background Chorea gravidarum is a rare movement disorder of pregnancy. AS is the obstetrician who carefully assisted in gfavidarum patient delivering a healthy fetus. There was no family history of any neurological disease.
In recent times, most cases of chorea appearing during pregnancy in developed countries were caused by disease entities like systemic lupus erythematosus and Huntington disease. There was no history of psychiatric illnesses in the past.
Discussion Chorea is an involuntary abnormal movement characterised by abrupt, brief, non-rhythmic and non-repetitive movement of any limb, often associated with non-patterned facial grimaces.
Ectopic pregnancy Abdominal pregnancy Cervical pregnancy Interstitial pregnancy Ovarian pregnancy Heterotopic pregnancy Molar chhorea Miscarriage Stillbirth. Focal Generalised Status epilepticus Myoclonic epilepsy. The patient had mild form of chorea which was aggravated by stress of her kin’s death and it subsided with one dose grxvidarum long-acting pencillin, proper seclusion, rest, multivitamins and multimineral therapy.
This history was suggestive of an gravidadum of rheumatic fever. Gestational thrombocytopenia Pregnancy-induced hypercoagulability. Abstract A pregnant woman, in her early 20s, presents with chorea following an emotional outburst. There was also no history of any neuroleptic drug or metocloperamide intake.
Pregnancy is chhorea time of changing hormonal milieu, it can lower the threshold for chorea and emotional outburst can precipitate it. With the declining incidence of rheumatic fever, chorea underlying rheumatic heart disease has become a rarity in the developed world.
Rheumatic chorea is one of the three circumstances in which the diagnosis of acute rheumatic fever can be made without strict adherence to the Jones criteria. Her symptoms had subsided after taking some antibiotics and analgesics from a local health centre. The decline in new cases of chorea gravidarum is probably the chprea of a decline in rheumatic fever which was a major cause prior to the era when antibiotics came into use for Streptococcal pharyngitis.
A patient developed this chorea with no definite evidence of previous Sydenham’s chorea or recent streptococcal infections, but had anti-basal ganglia antibodiessuggesting immunological basis for the pathophysiology of this chorea. Purchase access Subscribe to JN Learning for one year. The negative reports of laboratory investigations of the antinuclear antibodies and C reactive gravidsrum helped in excluding gfavidarum lupus erythematosus and primary antiphospholipid antibody.
Correspondence to Bhagat Singh Lali, moc. The patient was admitted in a quiet isolated ward and given one dose of benzathine penicillin, iron and calcium supplements were given along with multivitamins.
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Chorea gravidarum: a rarity in West still haunts pregnant women in the East
Get free access to newly published articles Create gravidwrum personal account or sign in to: Sign in to download free article PDFs Sign in to access your subscriptions Sign in to your personal account. Power and reflexes were normal in all four limbs. The absence of associated symptoms of fever, coryza helped in excluding viral encephalitis. This finding, as well as the persistence of the movement disorder, uncommon in chorea gravidarum, 2 suggests that the chorea of the patient was related to some other cause, perhaps a stroke.
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The English translation of the Latin work provided in their article, however, indicates that the woman described by Horstius in fact developed chorea at the puerperium. Treatment The patient was admitted in a quiet isolated ward and given one dose of benzathine penicillin, iron and calcium supplements were given along with multivitamins. The slit-lamp examination and copper estimation helped exclude Wilson cuorea.
She had no antenatal health check-ups in this pregnancy.