Neurorheumatism is a rheumatic disorder of the nervous system. Rheumatic disease, most often occurring with damage to the joints and heart, can also affect the nervous system, both peripheral (nerves) and central (brain). With damage to the peripheral nerves, disorders characteristic of neuritis or neuropathy appear. With brain damage, rheumatic meningitis or encephalitis can develop. The latter is the most common form of neurorheumatism, found mainly in children.
The disease is traditionally preceded by frequent tonsillitis, rheumatic heart disease, rheumatic joint damage; sometimes “small chorea” is the first manifestation of rheumatism in a child. The disease occurs at the age of 5-15 years, twice as often in girls. The disease can recur even at the age of 15-25; mostly in females.
Not often the disease begins with the appearance of irritability, absent-mindedness, stubbornness and “whims” of the child, sleep disturbances; at this stage, the diagnosis is difficult, since these symptoms are nonspecific. The motor disturbances that join later – awkwardness of movements, grimacing, hyperkinesis (for example, sniffing the nose, twitching the shoulders, “restlessness” in the hands) – already make one think about the “small chorea”. In the initial stages of the disease, hyperkinesis can be detected at the moment when the child takes off his clothes (“undressing symptom”). Writing, walking and speech are difficult, the child drops the fork, spoon. In severe cases, patients stop talking. With the emotional stress of the child, hyperkinesis intensifies. A symptom of the tongue and eyelids is characteristic – the child cannot keep his tongue hanging out with his eyes closed. Muscle tone decreases moderately or significantly; tendon reflexes are absent. There is no sensitivity disorder with “small chorea”. Internal organs and joints are affected little. In 50% of cases, the disease recurs, usually as a result of severe tonsillitis and especially in the autumn-spring periods.
Diagnosis of neurorheumatism is always difficult. If this disease is suspected, an examination by a neuropathologist will be necessary.
Treatment of neurorheumatism is determined by a neuropathologist together with a therapist; Start therapy traditionally in a hospital. When the severity of the process subsides, patients continue to be treated in a sanatorium. On an outpatient basis, patients with neurorheumatism need constant monitoring by a rheumatologist.