Chorea: symptoms and treatment
Chorea is a pathological condition characterized by the development of hyperkinesia of various body muscles. The person makes aimless, sweeping, chaotic and jerky movements, mainly upper and lower limbs. The basis of the disease is the damage to the basal ganglia of the brain, as well as the dentate nuclei of the cerebellum. This happens under the influence of various factors.
In most clinical situations, the reticular formation of the brain is also involved in the process. Because of all these pathological changes, the physiological process of dopamine transfer (neurotransmitter) is disrupted. As a result, this leads to sweeping and erratic movements of the muscles. Treatment of pathology will be lengthy and complex. The earlier the first symptoms are seen and the correct treatment is carried out, the more favorable the prognosis will be.
- hereditary forms. This includes Huntington’s chorea. This hereditary disease is of two types: chronic with late onset and not progressive with an early onset;
- chorea in extrapyramidal diseases. This type often develops in Lesch-Nayhan syndrome, hepatocerebral dystrophy;
- secondary forms. Occurs when the basal structures of the brain are affected. The reasons can be different — infection, trauma and so on. Secondary forms include small chorea. It develops because of getting into the circulatory system of streptococcal infection. The source can serve as carious teeth, inflamed tonsils. «Target organs» for infection: joints, heart valves, brain. The disease in most clinical cases affects small children, whose body is weakened. It is characterized by a recurring course.
- failure of the immune system
- burdened heredity. This is the cause of the development of Huntington’s chorea (genetic disease). The first symptoms of the presence of pathology in the body can appear only in 40 years. Before that, people can not even suspect that they are sick. Hyperkinesis appears against the background of emotional instability and developing dementia;
- brain injury;
- Cerebral Palsy;
- infectious diseases of a bacterial or viral nature, such as encephalitis, meningitis, etc.
- Vascular diseases that supply the brain with blood
- intoxication of the body
- metabolic disorders (bilirubin encephalopathy)
- rheumatism (in this case a person develops rheumatic chorea)
- systemic lupus erythematosus
The most common types of disease are:
- Houtington’s chorea. It can appear in a person at any age, but, as a rule, affects the body more often in 35-40 years. It is characterized by choreic hyperkinesia, dementia and personality disorders. The disease develops gradually and at its first stage it is almost impossible to notice hyperkinesis. Chaotic twitching can be noted in the face area. A man frowns or opens his mouth, licks his lips, puts out his tongue. The next symptom is «fingers playing the piano». After changing gait and statics, speech and swallowing are broken. Memory worsens, dementia develops. Man ceases to serve himself elementary. It is important to notice the first symptoms of the disease in a timely manner in order to consult a specialist and conduct adequate treatment;
- Sridenham’s chorea or rheumatic chorea. The disease develops after a short time after a streptococcal infection or exacerbation of rheumatic fever. Disease in most clinical cases is observed in childhood and adolescence. The most common are girls. Symptoms of the disease are clearly expressed. At the first stages of development of pathology, motor disinhibition is noted with grimacing and exaggerated gestures. If generalized hyperkinesis is more pronounced, the child completely loses the ability to service himself, dysarthria develops and respiratory function is impaired. All this makes his communication and movement impossible. In some cases, the stage of generalization of hyperkinesis is hemichorea. Characteristic of the appearance of muscle hypotension. Hyperkinesis regresses for three or six months. Chorea in children is more severe than in adults
- Chorea is pregnant. The disease develops in primiparous women, who in childhood suffered rheumatic chorea. Pathology is associated with the antiphospholipid syndrome. Disease, as a rule, develops on 3-5 months of pregnancy, also can recur in the following pregnancies. Symptoms occur spontaneously for several months.
In medicine, there are several symptoms that are characteristic of any kind of chorea:
- involuntary limb movements (an important diagnostic symptom)
- twitching your head
- decreased muscle tone
- impaired coordination of movements;
- gesticulation is strengthened;
- if you ask a person to write something, you can mark a change in handwriting;
- memory loss;
- Hyperkinesis disappears during sleep during this illness
- dancing gait
- temperature increase;
- all the movements that a person tries to control, he performs with great difficulty.
The diagnosis of chorea is based on the clinical picture of the disease and the patient’s complaints. For more information use laboratory and instrumental techniques:
- A blood test. This method allows to detect a decrease or increase in the level of leukocytes in the blood. This is typical for this disease. Also, the blood is checked to detect streptococcal infection in the patient’s body. For this purpose, attention is drawn to the indices of C-reactive protein, rheumatoid factor (especially important for the diagnosis of rheumatic chorea)
- electroencephalogram. The technique allows to catch even insignificant changes in brain activity;
- electromyography. Innovative technique, which allows to thoroughly study the biopotentials of muscles. With this disease, they will be lengthened;
- Computed tomography
When examining a patient, the doctor pays attention to the most characteristic symptoms of this disease — hyperkinesis and grimacing. The presence of these two signs already indicates that the person has a malfunction in the work of the nervous system. The treatment regimen will be selected based on the survey data.
Treatment of chorea should only be dealt with by a highly qualified doctor who can intelligently pick up the necessary plan of medical activities. Also, he will select the appropriate drugs and their dosage. Throughout the treatment period, therapy may vary slightly, depending on the improvement or deterioration of the patient’s condition.
Medication in the treatment of disease plays a key role. The patient is assigned the following groups of drugs:
- Neuroleptics. Most doctors prefer haloperidol. Often it is combined with reserpine, aminazine. Treatment is highly effective with a properly selected scheme;
- antibiotics. This group of synthetic medicines is used if the disease was caused by an infection. Drugs of choice — bicillin, penicillin
- sedatives. The barbiturate group is preferred;
In combination with drug therapy, vitamin therapy is used, as well as physiotherapy that reduces unpleasant symptoms. Good effect has radon baths, galvanization, electrosleep.