- Brain Invasion of Tonsillitis: Heart Rheumatism and Sydenham's Chorea
If your child has tonsillitis and makes strange dancing movements, you should read this article. .
Rheumatism of the heart, in other words acute rheumatic fever (ARA) is an inflammatory disease that develops approximately three weeks after a throat infection (pharyngitis) caused by group A streptococcus bacteria. This disease is a disease that affects the joints, heart and brain. It can most commonly affect all children between the ages of 5-15. Therefore, early diagnosis of throat and tonsil infections in children is important in preventing this disease. Tonsil infection causes rheumatism in twenty million children around the world every year. Cardiac rheumatism may begin with pain, swelling, redness, walking difficulty and pain in the joints after a throat infection.
Joint involvement is usually in the knee, arm and leg joints and is migratory. In other words, it first affects an arm joint and then affects the knee.
Cardiac rheumatism licks the joints and bites the heart. Joint findings improve immediately with treatment. However, when it affects the heart, it can progress insidiously over the years. Some of these children develop heart valve disease in adulthood.
Cardiac rheumatism affects the brain in some children. In this case, the disease we call Sydenham chorea develops. This disease develops in 10-15% of patients with rheumatic heart disease. It is more common in adolescent girls. It is thought to occur as a result of affecting the areas in the brain called basal ganglia. Symptoms of chorea appear three months or more after tonsil infection.
Emotional instability in children, failure at school, usually unilateral, involuntary, fast, irregular, purposeless and constantly strange movements in the trunk and especially in the arms and hands, and It begins with coordination disorder in the muscles. It is typical for involuntary movements to increase under stress and disappear during sleep. All muscles are affected, but symptoms are more pronounced in the facial muscles and arms, and contractions of the tongue may also occur. There is difficulty in keeping the tongue out. The patient moves constantly and grimaces. The patient cannot remain still. Speech is stuttering and explosive It happens in style. "Milking movement symptom" may be observed when the patient has to loosen the fingers clenched in his palm with irregular contractions. Shows clumsiness in handwriting. Emotional instability is characteristic. They cry easily and behave inappropriately.
Korea is a self-limiting disease. Symptoms may last for several months, and rarely up to two years. It may rarely recur. Chorea may also be a sign of an underlying rheumatic disease. In the long-term follow-up of patients showing symptoms of chorea, it was observed that rheumatism developed at a rate of 27%.
For this reason, children diagnosed with chorea should be followed up by a Pediatric Cardiologist.
>If strange movements such as dancing are observed in any child with tonsillitis, a Pediatric Neurologist should be consulted without delay. In this way, the disease will be diagnosed early and treatment will be given as soon as possible.
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