Objective: To determine significant criteria of disease and to predict development of movement disorders depending on severity of disease expression and duration for its promptly correction.

Background: Juvenila chorea: is a disease characterised by rheumatologic etology and movement disorders. Due to degenerative process in these areas of nerve system disrupts coordination of movements and muscle tone, showing hyperkinesia clinic.

Methods: 24 patients were monitored with juvenile chorea, with various severity of movement disorders, mean age was 14.4+-3.8, 16 girls and 8 boys. Patients were supervised during 6 years. Medical history and clinical manisfestation of motor disorders were studied carefully. Laboratory analysis of blood was conducted to detect streptococcus infection markers, EEG, EMG, MRI and MSCT of brain and in two severe cases were studied cerebrospinal fluid.

Results: Thus, almost in all children (100%) were detected irregular twitching muscles of trunk and face, in 75% noted involuntary uncoordinated movement of upper limbs with significant decrease in muscle tone. In 29.2 % patients were noted dancing gait, 91.7% patients couldn’t stand pose with clenched fist and put out the tongue, in 8.3% cases registered dysarthria, in 4.2% hyperkinesia followed with screaming. At an average, disease last up to 24 days. Repetitive choreic attacks were in 37.5% patients during 6 years. There was rheumatic polyarthritis in 83.4% patients’ anamnesis and rheumatic myocarditis in 66.7%. All patients had distinctly positive C-reactive protein, antistreptolisin O and rheum factor under such steady movement disorders and long-term course of disease. There was a diffuse slow-waved bioelectric activity on EEG and two of them had sharp and spike waves in fronto-patietal lead. During EMG registration were noted elongated potentials with more then 100 ms length, incipient asynchrony in antagonist-muscles. In cerebrospinal fluid was detected slightly pleocitosis which discriminate severity of disease course in patients. Ischemic lesions and tiny focuses were in putamen, caudate nucleus and thalamus during MRI and MSCT examination.

Conclusions: Thus, 6 years length monitoring of patients with juvenile chorea, comparable study of disease severity of motor disorders in line with laboratory and instrumental study gave a chance to predict severity of sub cortex impairment of rheumatic genesis.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/juvenile-chorea-diagnostic-criterias-prediction-of-movement-disorders/