Rheumatic chorea

Rheumatic chorea is a syndrome characterized by choreic movements, muscle weakness and emotional instability. It is one type of diseases of cardio vascular system. The aetiology are pharyngeal infection by group A streptococci, chorea is a delayed manifestation of rheumatic fever ,it is more common in females , in the age group 5-15 years, when no pervious rheumatic manifestations are noted, the term pure chorea is used. Some clinical features of this disease are mild form will appear like increased fidgetinesses and may be difficult to diagnose. Three signs which helpful in mild cases are 1.‘Milkmaid’s grip’ is due to inability to maintain muscles contraction. When the patient is asked to squeeze the examiner’s fingers, a squeezing and relaxing motion occurs, which is described as milkmaid’s grip, 2.’Bags of worm appearance’ is asynchronous contractions of the lingual muscles, 3.’Jack in the box sign’ –when patient is asked to keep the tongue protruded out, it retracts involuntarily .Well-established cases are easy to diagnose. Facial chorea results in frequent blinking and slurring of speech. These movements subside in sleep and get worsened with emotional disturbances, and during voluntary movements. Some management to follow is complete mental and physical rest and rheumatic fever prophylaxis.