Rheumatic chorea is a symptom of childhood rheumatic fever, characterized by involuntary muscle spasms and weakness. It can persist for months after treatment, but early treatment can prevent serious complications. Strep infections can lead to rheumatic fever and chorea, which affects young children in regions with poor healthcare. Diagnosis is made through symptoms and medical history, and treatment includes antibiotics and medication to reduce nervous system activity. Most children recover within five months.
Rheumatic chorea is a possible symptom of childhood rheumatic fever. It is characterized by involuntary muscle spasms and contractions, generalized muscle weakness, and poor coordination. Many patients who develop rheumatic chorea also experience other symptoms associated with the underlying bacterial infection such as rash, sore throat, and high fever. The infection can usually be cured in less than two weeks with oral or intravenous antibiotics, but rheumatic chorea symptoms can persist for several months after medical treatment. Most children who receive early treatment do not have serious and lasting complications.
Serious strep infections such as strep throat and scarlet fever that are not treated immediately can lead to symptoms of rheumatic fever. Chorea occurs when bacteria invade the central nervous system, triggering an inflammatory response by the immune system. As inflammation worsens, neurotransmitter receptor sites in the brain become damaged and nerve cells cannot communicate properly with muscle groups throughout the body. Rheumatic chorea most often affects young children living in regions with little or no access to quality health care.
Rheumatic chorea typically develops several days to weeks after the initial infection. Early symptoms may include weakness in the arms and inability to control fine motor movements. A child may also develop an awkward gait and experience uncontrollable muscle twitching in the face, arms and legs. In addition to muscle problems, some patients experience psychiatric changes, such as depression, extreme anxiety, or an inability to control emotions.
A doctor can usually diagnose rheumatic chorea by examining the patient’s symptoms and medical history. Blood tests may reveal active streptococcal infections or traces of antibodies that suggest an infection in the recent past. Because rheumatic fever has the potential to cause serious heart complications, ultrasound and echocardiograms are usually done for patients who have symptoms of chorea.
Rheumatic chorea often goes away on its own after the underlying infection has been treated with antibiotics. A prolonged course of antibiotics may also be given after symptoms have resolved to reduce the chances of recurring strep infections in young children. If a patient’s symptoms are severe enough to significantly interfere with their daily life, a doctor may prescribe additional medications. Anti-inflammatory steroids and anticonvulsant drugs such as carbamazepine and could be given to reduce the activity of the nervous system and allow the muscles to relax. In most cases, children are able to recover completely from rheumatic chorea in less than five months.
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