Chorea gravidarum: a rarity in West still haunts pregnant women in the East

Abstract

A pregnant woman, in her early 20s, presents with chorea following an emotional outburst. While the family members feel it to be a spirit haunting her, we try to establish the medical diagnosis of the present condition. There is a history of rheumatic fever in the past and examination reveals choreioathetoid jerky movements of her upper limbs with jerky speech, spooning of her limbs and demonstration of milkmaid's grip. Laboratory investigations did not reveal anything interesting. We discuss the diagnosis and management of this patient.

Corea Gravídica: reporte de caso y revisión de la literatura

“…Inicialmente se obtuvieron 32 títulos, al aplicar los criterios de selección quedaron 8 títulos, de las cuales 7 correspondieron a reportes de caso (1, 2, 8-12) y una revisión de tema (13). Estos reportes resumen la información de 7 pacientes en gestación con edades entre los 19 y 28 años, la etiología de la corea fue asociada a fiebre reumática (8,9), enfermedad de Moyamoya (2) y mutación del factor V de Leiden (10); la edad gestacional de presentación varió entre 8 y 40 semanas, con una mayor frecuencia en el primer trimestre (tabla 1). En un estudio publicado en el 2003 no fue posible obtener el texto completo (14).…”

“…El tratamiento instaurado fue sintomático con haloperidol (1, 10, 11) y benzodiacepinas más clorpromazina (12) con buen control de los movimientos. El tratamiento de la causa básica con penicilina cristalina se dio en un caso (8). En otro caso asociado a fiebre reumática no se utilizó tratamiento para estreptococo grupo A ( ).…”

Identifying the aetiology of sudden acute abnormal involuntary movements in a primigravid

“…There has been a steady decline in case reports among developed countries. According to Pathania et al , this syndrome has become a rarity in the Western world, however, its prevalence in developing countries remains 2. At present, the fetal and maternal mortality rate secondary to chorea gravidarum has been decreased from 50% and 13% to 3% and 2%, respectively 1.…”

“…Chorea gravidarum is commonly linked to conditions like lupus, antiphospholipid antibody syndrome, rheumatic fever, Wilson’s disease and Huntington’s disease 1. While the prevalence of this condition is rare among pregnant women in developed countries; there are still reports of its presence in many developing countries like the Philippines 2. Many obstetricians often overlook this rare condition, thus the need to further inform and raise awareness of chorea gravidarum’s possible manifestations.…”

Chorea Gravidarum Associated with Poor Perinatal Outcomes: Report of Two Cases

“…15 Though current literature suggest emotional shocks as the triggering factor for CG, 16,17 it is not clear whether complicated pregnancy is the emotional cause or result of CG. Taken together, intricate network of interaction between CG, and placental dysfunction secondary to hypertension/preeclampsia may be suggested.…”