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[Chorea: clinical analysis of 119 cases]
M F Mendes1, L A de Andrade, H B Ferraz
1Setor de Investigação em Moléstias Extrapiramidais da Disciplina de Neurologia da Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), Brasil.
Insights
Sydenham's chorea (SC) is the most common cause of chorea in Brazil, affecting over 51% of patients. This study highlights the prevalence of SC and other chorea etiologies in a Brazilian movement disorders unit.
Area of Science:
- Neurology
- Movement Disorders
- Clinical Syndromes
Context:
- Chorea is a neurological syndrome with diverse global etiologies.
- Understanding regional variations in chorea causes is crucial for diagnosis and treatment.
- Brazil presents a unique epidemiological profile for chorea.
Purpose:
- To investigate the etiological spectrum of chorea in a Brazilian university hospital.
- To analyze the prevalence of different chorea causes within the studied population.
- To propose an etiological classification of chorea based on clinical experience and literature review.
Summary:
- A retrospective study analyzed 119 patients diagnosed with chorea in Brazil.
- Sydenham's chorea (SC) was the predominant etiology (51.3%), followed by Huntington's chorea (18.5%) and post-stroke chorea (9.2%).
- SC, though less common in developed nations, remains prevalent in Brazil, particularly in younger females.
Impact:
- The findings emphasize the significant burden of Sydenham's chorea in Brazil.
- This study contributes to a better understanding of chorea's diverse etiologies in South America.
- The proposed etiological classification can aid clinicians in diagnosing and managing chorea patients effectively.
Abstract:
Chorea is a clinical syndrome characterized by abnormal involuntary arrhythmic movements, randomly distributed in time, affecting mainly the distal parts of the limbs. There are many diseases associated with chorea but the distribution of the etiologies vary too much in different parts of the world. We intended to study the etiologies of chorea in a Movement Disorders Unit of a university hospital-based outpatient clinic in Brazil. We studied the records of 119 patients with chorea based in the diagnostic criteria of the World Federation of Neurology. Sydenham's chorea (SC) was the most frequent cause of chorea (51.3%) of our sample. Other common causes were Huntington's chorea (18.5%) and chorea post-stroke (9.2%). SC is not commonly seen in developed countries nowadays but is not rare in Brazil. SC patients generally have the clinical manifestation of it in the first 20 years of age and girls are more affected than boys and this feature was observed in our sample. Based on our own experience and in the review of the literature we propose an etiological classification of chorea.