Movement Disorders Unit - Neurology Service, Department of Internal Medicine, The Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
Parkinsonism Relat Disord. 2012 Jun;18(5):458-61. doi: 10.1016/j.parkreldis.2011.12.013. Epub 2012 Jan 10.
Sydenham's Chorea is a frequent cause of chorea during pregnancy, chorea gravidarum. The aim of this article is to describe the effect of pregnancy in a consecutive series of patients with diagnosis of Sydenham's Chorea.
A chart review was performed of all patients with the diagnosis of Sydenham's Chorea followed up at our institution from 07/1993 through 08/2010 and who became pregnant.
From 66 patients, 20 became pregnant. Of these 20 patients, 15 (75%) developed chorea gravidarum. Generalized chorea was found in 67% of these 15 patients, focal or multifocal chorea was identified in 20% and 13.4% developed hemichorea. In 80% of cases chorea began in the first 6 months of gestation. Three women with previous persistent chorea experienced worsening of the movement disorder during pregnancy. Remission occurred after delivery in 11 patients whereas the other four remained with non-disabling chorea during the first 12 months after delivery. Abortion occurred in two patients (13%). All patients with chorea gravidarum subsequently treated with oral contraceptives developed recurrence of chorea.
Chorea gravidarum is a frequent complication of pregnancy in patients with previous history of Sydenham's Chorea and an increased risk of miscarriage should be considered. Our findings confirm the notion that chorea gravidarum results from hormonal changes acting on previously dysfunctional basal ganglia.
风湿性舞蹈病是妊娠性舞蹈病，即妊娠性舞蹈病的常见病因。本文旨在描述连续系列诊断为风湿性舞蹈病患者妊娠的影响。
对我院自 1993 年 7 月至 2010 年 8 月期间诊断为风湿性舞蹈病并怀孕的所有患者进行病历回顾。
在 66 例患者中，有 20 例怀孕。这 20 名患者中，有 15 名（75%）出现妊娠性舞蹈病。其中 15 名患者中有 67%出现全身性舞蹈病，20%出现局灶性或多灶性舞蹈病，13.4%出现偏侧舞蹈病。80%的病例在妊娠前 6 个月出现舞蹈病。3 名以前持续出现舞蹈病的患者在妊娠期间运动障碍加重。11 名患者在分娩后缓解，另外 4 名患者在分娩后 12 个月内仍存在非致残性舞蹈病。有 2 名患者（13%）流产。所有患有妊娠性舞蹈病的患者随后均采用口服避孕药治疗，再次出现舞蹈病。
有既往风湿性舞蹈病史的患者妊娠常并发妊娠性舞蹈病，应考虑流产的风险增加。我们的发现证实了妊娠性舞蹈病是由于激素变化作用于先前功能失调的基底节的观点。
