Avaliação de sinais e sintomas parkinsonianos em pacientes adultoscom história de Coréia de Sydenham

Abstract

Sydenhams chorea (SC), a neuropsychiatry disorder associated with Rheumatic Fever (RF), is thought to be related to dysfunction of fronto-striatal circuits caused by cross-reactive antibasal ganglia antibodies induced by -hemolytic group A Streptococcus (ABGA). These pa-tients could show parkinsonism after remission of chorea. Objective: To study the presence of parkinsonism in patients with history of SC, using de USCRS and UPDRS scales. Patients and Methods: We compared the frequency of parkinsonism in a group of 25 patients with ages above 16 years old, males and females, with history of SC, but without the symptoms of the disease and use of anti-choreic drugs. We evaluated the patients with the application of USCRS and UPDRS scales to determine the presence of parkinsonian signs and parkinsonism. Results: We found bradykinesia in 64% of the subjects. There was statistically significant corre-lation between bradykinesia and hemichorea (-0,412; p=0,036) and bradykinesia and generalized chorea (0,412; p=0,036). Psychiatric symptoms were more frequent in females patients (-0,439; p=0,047). No other correlations, including between bradykinesia and use of anti-choreic drugs, with the variables were detected. Conclusions: The present study demonstrated high frequency of bradykinesia in patients with remission of SC. The results suggest that this finding probably results from immune-mediated dysfunction of nigro-striatal system.