CHOREIFORM MOVEMENTS
CHOREIFORM MOVEMENTS: Excerpt from Algorithmic Diagnosis of Symptoms and Signs
Ask the following questions:
- What is the patient's age? Children are likely to develop Sydenham's chorea, Tourette's syndrome, or Wilson's disease. Huntington's chorea and senile chorea usually occur in adults.
- Is there associated fever or joint pains? The presence of fever or joint pains would make one think of Sydenham's chorea, encephalitis lethargica, or systemic lupus erythematosus.
- Is there a family history? A family history will be found in patients with Huntington's chorea, Tourette's syndrome, and Wilson's disease.
- Is there a history of drug ingestion? Several drugs can lead to choreiform movements, including the phenothiazines, levodopa, anticonvulsants, and birth control pills.
DIAGNOSTIC WORKUP
A toxicology screen is usually the first thing to be done. A sedimentation rate, ASO titer, streptozyme test, and EKG will help diagnose Sydenham's chorea. Serum copper and ceruloplasmin will help diagnose Wilson's disease. An ANA assay may be done in patients suspected of having lupus erythematosus. Young adults with high-risk sexual behavior require human immunodeficiency virus (HIV) testing. If these tests are unrewarding, a neurologist should be consulted.
Book Source Details
- Book Title: Algorithmic Diagnosis of Symptoms and Signs
- Author(s): R. Douglas Collins
- Year of Publication: 2003
- Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2003 Lippincott Williams & Wilkins.
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Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.
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