A 24 year old right handed Pakistani woman who was eight weeks’ pregnant presented with a two day history of involuntary movements of her left arm, hand. According to Willson and Preece, the first description of chorea with onset during pregnancy (chorea gravidarum) was made by Horstius in The English. A pregnant woman, in her early 20s, presents with chorea following an emotional outburst. While the family members feel it to be a spirit.

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A 22 years-old patient, second pregnancy, without prenatal care, who was admitted to the labor at It has been suggested that use of oral contraceptives is an infrequent cause of chorea.

Chorea in this case was helpful to the patient as she was started on penicillin prophylaxis which would prevent development of choea heart disease in future.

[Chorea gravidarum. A case report].

Please review our privacy policy. However, the scenario is different in developing countries like India where rheumatic fever still occurs frequently.

The first and second trimesters of her pregnancy had been uneventful. However, she denied any history of taking long-term injectable penicillin for the same. Extrapyramidal and movement disorders Pathology of pregnancy, childbirth and the puerperium.

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

Archives of Internal Medicine. According to Willson and Preece, 1 the first description of chorea with onset during pregnancy chorea gravidarum was made by Horstius in Sign in to access your subscriptions Sign in to your personal account. This page was last edited on 13 Decemberat SU was the psychiatrist who was regularly advising the patient.

Several pathogenetic mechanisms for chorea gravidarum have been offered, but none have been proven. A pregnant woman, in her early 20s, presents with chorea following an emotional outburst. Pregnancy is the chorsa of changing hormonal milieu, it can lower the threshold for chorea and emotional outburst can precipitate it.


It is a complication of pregnancy which can be associated with eclampsia and its effects upon the basal ganglia. Sensory system and all cranial nerve examination were normal with flexor plantar response. However, isolated cases still occur in the developing countries and obstetricians need to be aware of this rare manifestation.

Sign in to customize your interests Sign in to your personal account. Chorea gravidarum is a rare [1] type of chorea which presents with involuntary abnormal gravidaeum, characterized by abrupt, brief, nonrhythmic, nonrepetitive movement of any limb, often associated with nonpatterned facial grimaces.

Create a free personal account to download free article PDFs, sign up for alerts, and more. The Journal of Pediatrics.

[Chorea gravidarum. A case report].

While the gravicarum members feel it to be a spirit haunting her, we try to establish the medical diagnosis of the present condition. This finding, as well as the persistence of the movement disorder, uncommon in chorea gravidarum, 2 suggests that the chorae of the patient was gravidafum to some other cause, perhaps a stroke. She was discharged of the hospital four days later, having only abnormal movement in the right hand.

The relation to rheumatic fever was strengthened by many studies that showed that women with normal pregnancies before rheumatic fever developed chorea in subsequent pregnancies. The initial treatment was with diazepam, two days after the patient presented amniotic rupture without uterine activity, the pregnancy was interrupted by C- section and a male newborn was obtained.

Create a free personal account to access your subscriptions, sign up for alerts, and more. BSL compiled the case report and submitted it online. Abstract A pregnant woman, in her early 20s, presents with chorea following an emotional outburst. Willson P, Preece AA. History of either rheumatic fever or chorea is suspected: Drug treatment is indicated for patients with severe disabling chorea.

The patient herself complained of excessive salivation and she denied any movement disturbance. Get free access to newly published articles. Correspondence to Bhagat Singh Lali, moc. The patient was admitted in a quiet isolated ward and given one dose of benzathine penicillin, iron and calcium supplements were given along with multivitamins. In recent times, most cases of chorea appearing during pregnancy in developed countries were caused by disease entities like systemic lupus erythematosus and Huntington disease.


Rheumatic chorea is one of the three circumstances in which the diagnosis of acute rheumatic fever can be made without strict adherence to the Jones criteria.

Chorea gravidarum

Degenerative SA Friedreich’s ataxia Ataxia-telangiectasia. It is treated with haloperidol[9] [10] [11] chlorpromazine alone or in combination with diazepamand also pimozidewhich is another neuroleptic drug which may have fewer adverse effects than haloperidol.

Patients with Sydenham’s chorea are at risk for the development of rheumatic carditis particularly mitral stenosis and to prevent this, a regimen of daily penicillin prophylaxis should be instituted and maintained. gravidaruk

The choreic movements may be caused by ischaemia or enhanced dopaminergic sensitivity mediated by increased female hormones during pregnancy. Laboratory studies were as shown in table 1. In the 19th century, several authors 3 – 6 published important studies on chorea gravidarum that, along with the article by Willson and Cchorea, 1 helped to forge the contemporary way of viewing this peculiar form of chorea. She had four normal pregnancies more after, being the last the cborea of February of Focal Generalised Status epilepticus Myoclonic epilepsy.

Restricted unilateral Sydenham’s chorea: Sign in to save your search Sign in to your personal account. Our website uses cookies to enhance your experience.

The slit-lamp examination and copper estimation helped exclude Wilson disease. Published online Jun She had choreioathetoid, purposeless, irregular and jerky movements bilaterally in her upper limbs. As reported by Dilenge et al5 most cases of isolated Sydenham’s chorea will gravidarjm negative serology.

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