Rheumatic chorea is a syndrome that occurs when the basal ganglia are damaged – structures located deep in the cerebral hemispheres involved in the regulation of movements.
The reasons
The disease is closely related and often associated with exacerbations of rheumatism and endocarditis affecting the heart valves.
Symptoms
The disease develops slowly, gradually and is not immediately noticed by others. The patient begins to grimace, violent twitches in the arms and legs are found.
After a few days, the movements become fast, uncoordinated, there are many unnecessary movements that make it difficult to walk, write, eat. There is a sharp decrease in muscle tone.
The patient cannot stand, walk, speech and swallowing are sometimes disturbed.
In severe cases, the patient cannot remain calm for a minute – the limbs are scattered to the sides, the face is distorted by grimaces, the patient smacks his lips, cries out. Tendon reflexes are reduced.
The Gordon II reflex is characteristic of chorea minor (when the knee reflex is induced, the lower leg remains in the extension position for several seconds, caused by the contraction of the quadriceps femoris muscle).
Treatment
Bed rest.
Assign benzylpenicillin (potassium and sodium salts 150,000 IU four to five times a day intramuscularly) or bicillin or ekmonovocillin, amidopyrine (1-1.5 g per day for 8-10 days), sodium salicylate 0.5 g four times per day, butadione (0.075-0.15 g three times a day).
Cortisone (25 mg three times every day) is shown in combination with thiamine chloride and ascorbic acid, a complex mixture (adonizide, valerian tincture, motherwort tincture 5 ml each, sodium bromide – 3 g, distilled water – 200 ml) one tablespoon three times every day.
Also used is a galvanic collar according to Shcherbak with calcium chloride, electrosleep.