Sydenham Chorea
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Sydenham's chorea is a movement disorder that is the most common form of autoimmune chorea. It typically develops in children between ages 5-15 after a Group A beta-hemolytic streptococcal infection and is part of rheumatic fever. Symptoms include generalized chorea and other neurological symptoms like motor impersistence. Diagnosis involves looking for elevated antistreptococcal titers and imaging may show basal ganglia enlargement. Treatment considers severity, requirements, availability, cost, evidence and side effects. It is thought to be caused by molecular mimicry between streptococcal and human proteins that leads to an autoimmune response.
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This slide is prepared by medical student for educatonal purpose. Please comment if anything to add on this slide.Please share if youlike the slide in your educational group.
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CSD inservice
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1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
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1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
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Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
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Describe the primary categories of smells and the concept of odor blindness.
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Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
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Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
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Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
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Quality of a Good Odorant:
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Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
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Primary Sensations of Smell:
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Sydenham Chorea
- 1. A D E W I J A Y A , M D N O V E M B E R 2 0 1 9 Sydenham’s Chorea
- 2. Bridenbaugh S.A., Kressig R.W. (2018) Movement Disorders. In: Roller-Wirnsberger R., Singler K., Polidori M. (eds) Learning Geriatric Medicine. Practical Issues in Geriatrics. Springer, Cham
- 3. Outline: Introduction Clinical presentation Diagnosis Pathophysiology Treatment Summary
- 4. Introduction Most common form of autoimmune chorea Onset: age 5-15 Female > Male Usually develops 4–8 weeks after a group A beta- hemolytic streptococcal (GABHS) pharyngitis Part of Rheumatic Fever Resolve in 1-6 months Punukollu M, Mushet N, Linney M, Hennessy C, Morton M. Neuropsychiatric manifestations of Sydenham’s chorea: a systematic review. Dev Med Child Neurol. 2016;58:16–28.
- 5. Clinical Presentation Generalized chorea Hemichorea (25 %) Other neurological symptoms: motor impersistence, hypometric saccades, reduced muscle tone, tics, clumsiness, dysarthria, and weakness Profound hypotonia chorea paralytica or chorea mollis Neuropsychiatric symptoms, including obsessive compulsive behaviors, personality changes, emotional lability, distractibility, irritability, anxiety, age-regressed behaviors, and anorexia, are common and frequently predate the appearance of chorea Punukollu M, Mushet N, Linney M, Hennessy C, Morton M. Neuropsychiatric manifestations of Sydenham’s chorea: a systematic review. Dev Med Child Neurol. 2016;58:16–28.
- 6. Diagnosis Elevated antistreptococcal titers are present in about 15–30% imaging is usually normal, except for possible acute phase enlargement of the basal ganglia and increased T2 intensity in rare cases Giedd JN, Rapoport JL, Kruesi MJ, et al. Sydenham’s chorea: magnetic resonance imaging of the basal ganglia. Neurology. 1995;45:2199–2202.
- 7. Pathophysiology Cunningham, M. W., & Cox, C. J. (2016). Autoimmunity against dopamine receptors in neuropsychiatric and movement disorders: a review of Sydenham chorea and beyond. Acta Physiologica, 216(1), 90-100.
- 8. Treatment Dean, S. L., & Singer, H. S. (2017). Treatment of Sydenham’s chorea: a review of the current evidence. Tremor and Other Hyperkinetic Movements, 7.
- 9. Dean, S. L., & Singer, H. S. (2017). Treatment of Sydenham’s chorea: a review of the current evidence. Tremor and Other Hyperkinetic Movements, 7.
- 10. Treatment Consideration: - Severity of the problem - The requirement for a therapeutic agent - Availability - Cost - Supporting evidence - Side effects
- 11. Summary Is a movement disorder Most common form of autoimmune chorea Part of rheumatic fever Group A beta-hemolytic streptococcal (GABHS) Molecular mimicry Role for immunomodulatory therapy
- 12. THANK YOU