I02.0

Clinical Causes: Recent infection with group A streptococcus bacteria, often causing streptococcal pharyngitis (strep throat). Autoimmune response where the immune system mistakenly attacks the brain and heart tissues following infection. Genetic predisposition may increase vulnerability to developing rheumatic fever and its neurological or cardiac complications.

Key Symptoms: Involuntary, rapid, and unpredictable movements primarily affecting the face, limbs, and trunk. Muscle weakness or tension may be present during episodes. Emotional disturbances such as irritability, emotional lability, or behavioral changes. Speech difficulties, including slurred or strained speech. Chorea movements worsening with rest and improving with activity. Signs of cardiac involvement, possibly including murmurs, chest pain, or shortness of breath. Fever, fatigue, and joint pains often preceding neurological symptoms.

Diagnosis Path: Clinical evaluation of neurological signs and observation of choreiform movements. History of recent streptococcal infection. Blood tests showing elevated inflammatory markers (ESR, CRP) and evidence of streptococcal infection (ASO titers). Electrocardiogram (ECG) to identify cardiac involvement or abnormalities. Echocardiography to assess heart function and detect valvular damage. Additional tests such as throat swab or rapid antigen detection tests may confirm recent strep infection.

Treatment Protocols: Antibiotics, like penicillin, to eradicate streptococcal bacteria and prevent recurrence of rheumatic fever. Anti-inflammatory medications such as aspirin or corticosteroids to reduce inflammation and control symptoms. Medications like dopamine antagonists or neuroleptics for controlling choreiform movements if necessary. Managing cardiac symptoms with appropriate cardiological interventions and monitoring. Supportive therapies including physical therapy, speech therapy, and psychological support to assist with movement difficulties and emotional challenges. Long-term prophylactic antibiotics may be required to prevent future streptococcal infections and worsening of rheumatic fever.