Other chorea. G25.5 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2019 edition of ICD-10-CM G25.5 became effective on October 1, 2018. This is the American ICD-10-CM version of G25.5 - other international versions of ICD-10 G25.5 may differ.
Sydenham's chorea is an autoimmune disease that results from childhood infection with Group A beta- haemolytic Streptococcus. It is reported to occur in 20–30% of people with acute rheumatic fever and is one of the major criteria for it, although it sometimes occurs in isolation.
S2CID 3234882. ^ Dean, Shannon L.; Singer, Harvey S. (1 June 2017). "Treatment of Sydenham's Chorea: A Review of the Current Evidence". Tremor and Other Hyperkinetic Movements. 7: 456. doi: 10.7916/d8w95gj2. PMC 5459984. PMID 28589057.
Diagnosis is often delayed and attributed to another condition such as tic disorder or conversion disorder. The controversial PANDAS (pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections) hypothesis has overlapping clinical features but Sydenham's chorea is one of the exclusion criteria.
Definition. Sydenham chorea (SC) is a neurological disorder of childhood resulting from infection via Group A beta-hemolytic streptococcus (GABHS), the bacterium that causes rheumatic fever. SC is characterized by rapid, irregular, and aimless involuntary movements of the arms and legs, trunk, and facial muscles.
ICD-10-CM Code for Other chorea G25. 5.
How is Sydenham chorea diagnosed? Healthcare providers ask about your child's medical history, symptoms and potential exposure to Group A beta-hemolytic Streptococcus. A blood test to detect strep antibodies may support the diagnosis.
Sydenham chorea is considered a disease of childhood; however, it also may be seen in adults. Rheumatic chorea is characterized by muscle weakness and the presence of chorea. The patients have the milkmaid grip sign, clumsy gait, and explosive bursts of dysarthric speech.
Definition. Chorea is an abnormal involuntary movement disorder, one of a group of neurological disorders called dyskinesias, which are caused by overactivity of the neurotransmitter dopamine in the areas of the brain that control movement.
The most common signs of chorea are:Involuntary muscle movements: Also called fidgety movements or dance-like movements usually appear in the hands, feet, and face. ... Milkmaid's grip: Rather than holding your hand steady when you try to shake someone's hand, you may grip and release your fingers over and over again.More items...•
Children with Sydenham's chorea require long-term benzathine penicillin prophylaxis to reduce the risk of rheumatic heart disease. In contrast, the efficacy of penicillin prophylaxis in preventing tic or obsessive-compulsive symptom exacerbations in children with PANDAS remains doubtful.
Sydenham chorea mainly involves jerky, uncontrollable and purposeless movements of the hands, arms, shoulder, face, legs, and trunk. These movements look like twitches, and disappear during sleep. Other symptoms may include: Changes in handwriting.
Sydenham chorea, also known as St. Vitus dance, is a neuropsychiatric manifestation of rheumatic fever with an incidence varying from 5 to 35%. It may occur alone or concomitantly with other manifestations of rheumatic fever.
The name St. Vitus Dance derives from the late Middle Ages, when persons with the disease attended the chapels of St. Vitus, who was believed to have curative powers. The disorder was first explained by the English physician Thomas Sydenham.
HD History His description was based on observations of HD-affected families from the village of East Hampton, Long Island, New York (USA), where Dr Huntington lived and worked. HD was known as Huntington's chorea and Saint Vitus's dance in the past.
The original descriptions of chorea date from the Middle Ages, when an epidemic of “dancing mania” swept throughout Europe. The condition was initially considered a curse sent by a saint, but was named “Saint Vitus's dance” because afflicted individuals were cured if they touched churches storing Saint Vitus's relics.
Tics are the most common hyperkinetic disorder in children. Dystonia, stereotypies, choreoathetosis, tremors, and myoclonus also occur but are less common. Many hyperkinetic movement disorders manifest with multiple types of movements, which may include a combination of the various hyperkinesias.
ICD-10 code G24. 9 for Dystonia, unspecified is a medical classification as listed by WHO under the range - Diseases of the nervous system .
Hemiballismus is usually caused by a lesion in the contralateral STN. This is usually an infarct around the nucleus. This condition is very rare and is classified as a type of chorea. Additional causes of hemiballismus include traumatic brain injury, ALS, neoplasms, demyelinating plaques, and others.
2.
Acute, usually self-limited disorder of early life, usually between ages 5 and 15 , or during pregnancy, and closely linked with rheumatic fever; characterized by involuntary movements that gradually become severe, affecting all motor activities including gait, arm movements, and speech; called also sydenham's, acute, juvenile, or simple chorea, or st. Vitus dance.
The 2022 edition of ICD-10-CM I02 became effective on October 1, 2021.
Sydenham's chorea became a well-defined disease entity only during the second half of the nineteenth century. Such progress was promoted by the availability of large series of clinical data provided by newly-founded paediatric hospitals.
Sydenham's chorea is an autoimmune disease that results from childhood infection with Group A beta- haemolytic Streptococcus. It is reported to occur in 20–30% of people with acute rheumatic fever and is one of the major criteria for it, although it sometimes occurs in isolation.
The disease occurs typically a few weeks, but up to 6 months, after the acute infection, which may have been a simple sore throat ( pharyngitis ). Sydenham's chorea is more common in females than males and most cases affect children between the ages of 5 and 15 years of age.
As with rheumatic fever, Sydenham's chorea is seen more often in less affluent communities, whether in the developing world or in aboriginal communities in the global North. High rates of impetigo are a marker for widespread streptococcal transmission.
The diagnosis is then made by the typical acute onset in the weeks following a sore throat or other minor infection , plus evidence of inflammation (raised CRP and/or ESR) and evidence of recent streptococcal infection.
Other disorders that may be accompanied by chorea include benign hereditary chorea, bilateral striatal necrosis, abetalipoproteinemia, ataxia–telangiectasia, biotin-thiamine-responsive basal ganglia disease, Fahr disease, familial dyskinesia–facial myokymia (Bird–Raskind syndrome) due to an ADCY5 gene mutation, glutaric aciduria, Lesch–Nyhan syndrome, mitochondrial disorders, Huntington's disease, Wilson disease, hyperthyroidism, lupus erythematosus, pregnancy ( chorea gravidarum ), drug intoxication and side effects of certain anticonvulsants (e.g. phenytoin) or psychotropic agents. Although some of these can similarly present in an acute way, there will typically be other neurological signs (such as ataxia or cognitive impairment), or other disease manifestations, or positive family history, which will help distinguish between them.
Immunosuppression is used inconsistently in Sydenham's chorea. The model of an autoimmune disorder would support its use. One randomized controlled trial of steroids from Paz, Brazil in 2006 (22 cases) showed remission reduced to 54 days from 119 days. Various other reports of use of oral or IV steroids from Israel, Italy and Brazil . Immunoglobulin has been used in Holland and South Africa. Some improvement can be seen within a few days of IV steroids. In Italy, prednisolone reduced average duration of symptoms from 9 weeks to 4 weeks, and these were severe cases. South African group found less neuropsychiatric complications at 6 months with IVIG treatment (IVIG preferred due to fear of TB reactivation).
Sydenham's chorea, also known as chorea minor and historically and occasionally referred to as St Vitus' dance, is a disorder characterized by rapid, uncoordinated jerking movements primarily affecting the face, hands and feet. Sydenham's chorea is an autoimmune disease that results from childhood infection with Group A beta-haemolytic Streptococcus. It is reported to occur in 20–30% of people with acute rheumatic fever and is one of the major criteria for it, although it sometimes …
Sydenham's chorea is characterized by the abrupt onset (sometimes within a few hours) of neurologic symptoms, classically chorea, which are non-rhythmic, writhing or explosive involuntary movements. Usually all four limbs are affected, but there are cases reported where just one side of the body is affected (hemichorea). Typical chorea includes repeated wrist hyperextension, grimacing, lip pouting. The fingers can move as if playing the piano. There may be tongue fascic…
Other disorders that may be accompanied by chorea include benign hereditary chorea, bilateral striatal necrosis, abetalipoproteinemia, ataxia–telangiectasia, biotin-thiamine-responsive basal ganglia disease, Fahr disease, familial dyskinesia–facial myokymia (Bird–Raskind syndrome) due to an ADCY5 gene mutation, glutaric aciduria, Lesch–Nyhan syndrome, mitochondrial disorders, Huntington's disease, Wilson disease, hyperthyroidism, lupus erythematosus, pregnancy (chorea …
One of the important manifestations of acute rheumatic fever, Sydenham's chorea is similarly caused by an autoimmune response following infection by group A β-hemolytic streptococci.
Two cross reactive streptococcal antigens have been identified, the M protein and N-acetyl-beta-D-glucosamine, whereby infection leads to autoantibodies being produced against host tissues (molecular mimicry) causing a variety of streptococcal related diseases including Sydenham's ch…
As with rheumatic fever, Sydenham's chorea is seen more often in less affluent communities, whether in the developing world or in aboriginal communities in the global North. High rates of impetigo are a marker for widespread streptococcal transmission.
Chorea is distinctive, if the health care provider is familiar with it. The diagnosis is then made by the typical acute onset in the weeks following a sore throat or other minor infection, plus evidence of inflammation (raised CRP and/or ESR) and evidence of recent streptococcal infection.
To confirm recent streptococcal infection:
• Throat culture
Management of Sydenham's chorea is based on the following principles:
1. Eliminate the streptococcus – it may not be of any use for the index patient but further spread of that specific clone will be prevented.
2. Treat the movement disorder
3. Immunosuppression
Motor problems including chorea settle within an average of 2–3 months.
Recurrence seen in 16–40% of cases. Recurrence is more likely with poor compliance with penicillin prophylaxis. Intramuscular penicillin is given every 2–3 weeks superior to 4 weekly regime, and oral penicillin is also prescribed. Recurrences are sometimes associated with rise in ASO titre or other evidence of new streptococcal infection. There is no obvious clinical paramete…