AI Article Synopsis
- Chorea is a movement disorder in children that requires careful diagnosis to identify treatable underlying conditions, which can enhance their quality of life.
- A study conducted on 81 pediatric patients in Bogotá identified rheumatic fever as the most common cause of chorea, followed by vascular issues and lupus, with older children more likely to have rheumatic fever.
- The research highlighted key indicators for differentiating causes, such as age and accompanying neurological symptoms, and found a significant relationship between age and psychiatric symptoms, showing these symptoms are common in children with movement disorders.
Article Abstract
Background: Chorea is a common movement disorder in children, requiring thorough clinical assessment and appropriate tests for etiological diagnosis. Early identification of treatable conditions can lead to effective treatment, reducing morbidity and improving quality of life.
Objective: To describe the clinical, demographic, and epidemiological characteristics of children and adolescents diagnosed with chorea.
Methods: A retrospective cross-sectional study of pediatric patients treated in a fourth-level hospital in Bogotá, Colombia, from January 2008 to January 2022.
Results: 81 patients with chorea were found. The most frequent etiologies were rheumatic fever (50.6 %), vascular chorea (29.3 %), and chorea secondary to lupus (11.1 %). Patients with chorea secondary to rheumatic fever (Sydenham's chorea) were older compared to other etiologies, 10.36 ± 3.41 years vs 8.29 ± 5.16, p = 0.037. The presence of another movement disorder or abnormalities during the physical examination suggests a different etiology from rheumatic fever. Moreover, the presence of psychiatric symptoms was similar in all etiologies. However, a correlation between age and psychiatric symptoms was observed with an odds ratio of 1.14 95 % CI 1.02-1.29 per year.
Conclusions: Red flags in Sydenham's chorea suggesting an alternate etiology are younger age, the presence of other abnormal movements or other findings in the neurological exam or in the magnetic resonance imaging. No significant statistical differences were found between the etiologies with the presence of neuro-psychiatric manifestations. Nevertheless, these manifestations are very frequent in abnormal movements. This study evidenced the positive correlation between age and the presence of psychiatric symptoms.
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| http://dx.doi.org/10.1016/j.braindev.2024.08.005 | DOI Listing |
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