DISEASES OF THE NERVOUS SYSTEM : CHOREA (CHOREA MINOR0R) - etiology, pathogenesis, symptoms and course of, recognition, prediction and prevention
Chorea may occur as an independent disease as a symptom of other organic diseases (encephalitis, tumor, vascular lesion). Chorea in children is a form of rheumatism. Sometimes chorea occurs in pregnant women (choreagravidarum). In the pathogenesis of acute horei can play the role of an allergic condition. The main pathological process is localized in the striatum corpus. Possible choreiform type of car and the localization process in the anterior paired cerebellar peduncles.
Symptoms. Infectious chorea sometimes begins acutely, often develops gradually: the patient is cranky, distracted, irritable, then you receive hyperkinesis, often in the hands; sometimes it spreads to the face, torso, legs. Hyperkinesis is a character constant, random motion (faces of the face, flexion, extension, adduction and abduction of the fingers). Along with hyperkinesis, changes the tone, which then decreases, then increases, and these changes lead to different poses:
Notes reflex Gordon: in the induction of knee reflex Shin freezes at some time in the phase of extension. Often there is hypotonia of the muscles. Severe infectious herei last up to several months, light can pass in a few weeks. Chorea tend to give relapses, especially in the presence of chronic infectious foci, such as tonsillitis.
In children it is necessary to exclude various policies: they are more localized, asprovided changes of tone, not progress. For hysteria, accompanied by hyperkinesia, and other typical features of this disorder (see Mental illness, Hysteria); often occurs on the basis of imitation. It is necessary to exclude encephalitis and swelling, which may be symptomatic choreiform twitching. In adults choreiform hyperkinesis may occur and on the basis of arteriosclerosis.
When infectious trochaic in the acute period, the patient should remain on bed rest. Infusion of 40% solution of urotropine, sulfa drugs (streptocid), penicillin. Give salicylates, aspirin; antipyrine in combination with arsenic, piramidon with Acidi arsenicosi (Filatov). Always designate bromides; severe anxiety intravenous infusion of sodium bromide (10%) 5 - 10 ml and a warm bath (37 - 38º), wraps. When recurrent trochaic with tonsillitis - tonsil - ectomy. In addition to this therapy, etiological treatment. When syphilis in anamnesis should test protevoepilepticescoe treatment (see Venereal disease, Syphilis). When is the critical period - rhythmic gymnastics physiotherapy (if no contraindications cardio-vascular system).