Sydenham's Chorea
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Sydenham's Chorea
Sydenham's chorea, also known as rheumatic chorea, is a disorder characterized by rapid, uncoordinated jerking movements primarily affecting the face, hands and feet. Sydenham's chorea is an autoimmune disease that results from childhood infection with Group A beta-haemolytic ''Streptococcus''. It is reported to occur in 20–30% of people with acute rheumatic fever and is one of the major criteria for it, although it sometimes occurs in isolation. The disease occurs typically a few weeks, but up to 6 months, after the acute infection, which may have been a simple sore throat (pharyngitis). Sydenham's chorea is more common in females than males, and most cases affect children between the ages of 5 and 15 years of age. Adult onset of Sydenham's chorea is comparatively rare, and the majority of the adult cases are recurrences following childhood Sydenham's chorea. It is historically one of the conditions called '' St Vitus' dance''. Signs and symptoms Sydenham's chorea is chara ...
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Chorea
Chorea (or choreia, occasionally) is an abnormal involuntary movement disorder, one of a group of neurological disorders called dyskinesias. The term ''chorea'' is derived from the grc, χορεία ("dance"; see choreia), as the quick movements of the feet or hands are comparable to dancing. The term hemichorea refers to chorea of one side of the body, such as chorea of one arm but not both (analogous to hemiballismus). Presentation 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. These 'dance-like' movements of chorea often occur with athetosis, which adds twisting and writhing movements. 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, ...
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Gait
Gait is the pattern of movement of the limbs of animals, including humans, during locomotion over a solid substrate. Most animals use a variety of gaits, selecting gait based on speed, terrain, the need to maneuver, and energetic efficiency. Different animal species may use different gaits due to differences in anatomy that prevent use of certain gaits, or simply due to evolved innate preferences as a result of habitat differences. While various gaits are given specific names, the complexity of biological systems and interacting with the environment make these distinctions "fuzzy" at best. Gaits are typically classified according to footfall patterns, but recent studies often prefer definitions based on mechanics. The term typically does not refer to limb-based propulsion through fluid mediums such as water or air, but rather to propulsion across a solid substrate by generating reactive forces against it (which can apply to walking while underwater as well as on land). Due to th ...
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Benign Hereditary Chorea
Benign hereditary chorea (BHC), also known as benign familial chorea, is a rare autosomal dominant neurogenetic syndrome. It typically presents itself in childhood with isolated chorea, with average to below average intelligence. Unlike other neurogenetic causes of chorea such as Huntington's disease, BHC is not progressive, and not associated with cognitive decline or psychiatric problems in the vast majority of cases. The first description of BHC was reported in 1967 in an African American family from Mississippi. Two brothers reportedly had delayed motor development in childhood and were diagnosed with chorea. These findings were reaffirmed by other families reporting similar traits and an autosomal dominant pattern of inheritance was suggested. However, heterogeneity in the presentations of the affected individuals made confirmation of these diagnoses of BHC difficult to prove. Features reported in these families, including dystonia, tremor, and myoclonus, led researchers to ...
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Obsessive–compulsive Disorder
Obsessive–compulsive disorder (OCD) is a mental and behavioral disorder in which an individual has intrusive thoughts and/or feels the need to perform certain routines repeatedly to the extent where it induces distress or impairs general function. As indicated by the disorder's name, the primary symptoms of OCD are obsessions and compulsions. Obsessions are persistent unwanted thoughts, mental images, or urges that generate feelings of anxiety, disgust, or discomfort. Common obsessions include fear of contamination, obsession with symmetry, and intrusive thoughts about religion, sex, and harm. Compulsions are repeated actions or routines that occur in response to obsessions. Common compulsions include excessive hand washing, cleaning, counting, ordering, hoarding, neutralizing, seeking assurance, and checking things. Washing is in response to the fear of contamination. Ordering is the preference for tasks to be completed a specific way (e.g., organizing clothes a specific w ...
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PANDAS
Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) is a controversial hypothetical diagnosis for a subset of children with rapid onset of obsessive-compulsive disorder (OCD) or tic disorders. Symptoms are proposed to be caused by group A streptococcal (GAS), and more specifically, group A beta-hemolytic streptococcal (GABHS) infections. OCD and tic disorders are hypothesized to arise in a subset of children as a result of a post-streptococcal autoimmune process. The proposed link between infection and these disorders is that an autoimmune reaction to infection produces antibodies that interfere with basal ganglia function, causing symptom exacerbations, and this autoimmune response results in a broad range of neuropsychiatric symptoms. The PANDAS hypothesis, first described in 1998, was based on observations in clinical case studies by Susan Swedo ''et al'' at the US National Institute of Mental Health and in subsequent clinical ...
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Conversion Disorder
Conversion disorder (CD), or functional neurologic symptom disorder, is a diagnostic category used in some psychiatric classification systems. It is sometimes applied to patients who present with neurological symptoms, such as numbness, blindness, paralysis, or fits, which are not consistent with a well-established organic cause, which cause significant distress, and can be traced back to a psychological trigger. It is thought that these symptoms arise in response to stressful situations affecting a patient's mental health or an ongoing mental health condition such as depression. Conversion disorder was retained in DSM-5, but given the subtitle functional neurological symptom disorder. The new criteria cover the same range of symptoms, but remove the requirements for a psychological stressor to be present and for feigning to be disproved. ICD-10 classifies conversion disorder as a dissociative disorder while DSM-IV classifies it as a somatoform disorder. Signs and symptoms ...
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Tic Disorder
Tic disorders are defined in the ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM) based on type (motor or phonic) and duration of tics (sudden, rapid, nonrhythmic movements). Tic disorders are defined similarly by the World Health Organization (ICD-10 codes). Classification DSM-5 The fifth revision of the ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM-5), published in May 2013, classifies Tourette syndrome and tic disorders as motor disorders listed in the neurodevelopmental disorder category. Tic disorders, in ascending order of severity, are: * 307.20 Other specified tic disorder (specify reason) * 307.20 Unspecified tic disorder * 307.21 Provisional tic disorder * 307.22 Persistent (chronic) motor or vocal tic disorder (specify motor or vocal) * 307.23 Tourette's disorder Developmental coordination disorder and stereotypic movement disorder are also classified as motor disorders. ICD-10 ICD10 diagnosis codes are: * F95.0 Transient tic disor ...
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Stereotypies
A stereotypy (, or ) is a repetitive or ritualistic movement, posture, or utterance. Stereotypies may be simple movements such as body rocking, or complex, such as self-caressing, crossing and uncrossing of legs, and marching in place. They are found especially in people with autism spectrum disorders and visually impaired children, and are also found in intellectual disabilities, tardive dyskinesia and stereotypic movement disorder, yet may also be encountered in neurotypical individuals as well. Studies have shown stereotypies associated with some types of schizophrenia. Frontotemporal dementia is also a common neurological cause of repetitive behaviors and stereotypies. Several causes have been hypothesized for stereotypy, and several treatment options are available. Stereotypy is sometimes called ''stimming'' in autism, under the hypothesis that it self-stimulates one or more senses. Among people with frontotemporal lobar degeneration, more than half (60%) had stereotypies ...
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Tics
A tic is a sudden, repetitive, nonrhythmic motor movement or vocalization involving discrete muscle groups.American Psychiatric Association (2000)DSM-IV-TR: Tourette's Disorder.''Diagnostic and Statistical Manual of Mental Disorders'', 4th ed., text revision (DSM-IV-TR), . Available at BehaveNet.com Retrieved on August 10, 2009. Tics can be invisible to the observer, such as abdominal tensing or toe crunching. Common motor and phonic tics are, respectively, eye blinking and throat clearing. Tics must be distinguished from movements of disorders such as chorea, dystonia and myoclonus; the compulsions of obsessive–compulsive disorder (OCD) and seizure activity; and movements exhibited in stereotypic movement disorder or among autistic people (also known as stimming). Classification Tics are classified as either motor or phonic, and simple or complex. Motor or phonic Motor tics are movement-based tics affecting discrete muscle groups. Phonic tics are involuntary sounds prod ...
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Erythema Marginatum
Erythema marginatum is a type of erythema (redness of the skin or mucous membranes) involving pink rings on the torso and inner surfaces of the limb (anatomy), limbs which come and go for as long as several months. It is found primarily on extensor surfaces. An association with bradykinin has been proposed in the case of hereditary angioedema. Presentation The rings are barely raised and are non-pruritus, itchy. The face is generally spared. Associated conditions It occurs in less than 5% of patients with rheumatic fever, but is considered a major Rheumatic fever#Diagnosis, Jones criterion when it does occur. The four other major criteria include carditis, polyarthritis, Sydenham's chorea, and subcutaneous nodules. In this case, it is often associated with Group A streptococcal infection, otherwise known as ''Streptococcus pyogenes'' infection, which can be detected with an ASO titer. It is an early feature of rheumatic fever and not pathognomonic of it. It may be associated wi ...
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Nodule (medicine)
In medicine, nodules are small firm lumps, usually greater than 1 cm in diameter. If filled with fluid they are referred to as cysts. Smaller (less than 0.5 cm) raised soft tissue bumps may be termed papules. The evaluation of a skin nodule includes a description of its appearance, its location, how it feels to touch and any associated symptoms which may give clues to an underlying medical condition. Nodules in skin include dermatofibroma and pyogenic granuloma. Nodules may form on tendons and muscles in response to injury, and are frequently found on vocal cords. They may occur in organs such as the lung, or thyroid, or be a sign in other medical conditions such as rheumatoid arthritis. Characteristics Nodules are small firm lumps usually greater than 1 cm in diameter, found in skin and other organs. If filled with fluid they are usually softer and referred to as cysts. Smaller (less than 0.5 cm) raised soft tissue bumps may be termed papules. Evaluation The evaluation of a ...
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Erythema Marginatum
Erythema marginatum is a type of erythema (redness of the skin or mucous membranes) involving pink rings on the torso and inner surfaces of the limb (anatomy), limbs which come and go for as long as several months. It is found primarily on extensor surfaces. An association with bradykinin has been proposed in the case of hereditary angioedema. Presentation The rings are barely raised and are non-pruritus, itchy. The face is generally spared. Associated conditions It occurs in less than 5% of patients with rheumatic fever, but is considered a major Rheumatic fever#Diagnosis, Jones criterion when it does occur. The four other major criteria include carditis, polyarthritis, Sydenham's chorea, and subcutaneous nodules. In this case, it is often associated with Group A streptococcal infection, otherwise known as ''Streptococcus pyogenes'' infection, which can be detected with an ASO titer. It is an early feature of rheumatic fever and not pathognomonic of it. It may be associated wi ...
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