What is Chorea Gravidarum? This condition is characterized by abrupt, abnormal, involuntary movements that are non-rhythmic, brief and sporadic movements of any limb. These movements are commonly associated with non-patterned grimacing of the face. Chorea gravidarum is not a pathologically or etiologically distinct fatal condition, but is a broad term used when a woman experiences chorea from any cause during her pregnancy. Rheumatic fever is thought to be a major cause of chorea gravidarum.
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What is Chorea Gravidarum? This condition is characterized by abrupt, abnormal, involuntary movements that are non-rhythmic, brief and sporadic movements of any limb. These movements are commonly associated with non-patterned grimacing of the face. Chorea gravidarum is not a pathologically or etiologically distinct fatal condition, but is a broad term used when a woman experiences chorea from any cause during her pregnancy.
Rheumatic fever is thought to be a major cause of chorea gravidarum. There has been decrease in the incidence of chorea gravidarum because of decrease in the cases of Rheumatic fever.
Majority of the patients had a previous history of either chorea or rheumatic fever. This goes to suggest that hormones, progesterone and estrogen, can lead to sensitization of the dopamine receptors and lead to chorea in patients who are prone to this complication from preexisting pathology in the basal ganglion. Autopsy on the patients with chorea gravidarum has revealed pathological changes such as perivascular degeneration in the caudate nucleus. Rheumatic brain disease shows pathology of nonspecific arteritis with perivascular lymphocytic infiltration, endothelial swelling and petechial hemorrhages.
There is absence of Aschoff bodies. These changes are more apparent in the corpus striatum. There is severe neuronal loss in the putamen and caudate nucleus and these pathologic changes have been observed in chorea gravidarum; however, those patients also suffered from cardiac disease. It is thought that as the inflammation abates, the chorea also resolves with degenerative changes still remaining in the small arterioles.
Advertisement There is also thought to be a possible relationship between moyamoya disease and chorea gravidarum. The movements of chorea are thought to occur as a result of ischemia or increased dopaminergic sensitivity, which is facilitated by the increase in the female hormones during pregnancy. Such mothers or patients are more prone to develop seizures, rhabdomyolysis , hemiplegia, hyperthermia and coma. The symptoms of chorea gravidarum usually subside in the mid to late second trimester.
There is an elevation in the Anti-streptolysin O antibodies, which may continue to remain elevated throughout the pregnancy. Patients often also have valvular heart disease; however, the patients usually respond well to medical intervention, supportive therapy and reassurance.
Diagnosis of Chorea Gravidarum Medical history and physical examination of the patient is carried out. Various investigations are carried out to confirm the diagnosis of chorea gravidarum. Imaging studies are also important for diagnosis. The different tests and investigations done for confirmation of diagnosis of chorea gravidarum include: MRI scan of the brain.
What is Chorea Gravidarum & How is it Treated?
Learn how and when to remove this template message Chorea is characterized by brief, semi-directed, irregular movements that are not repetitive or rhythmic, but appear to flow from one muscle to the next. Walking may become difficult, and include odd postures and leg movements. Unlike ataxia , which affects the quality of voluntary movements, or Parkinsonism , which is a hindrance of voluntary movements, the movements of chorea and ballism occur on their own, without conscious effort. Thus, chorea is said to be a hyperkinetic movement disorder.
What Is Chorea?