Rossi Elisa, Strano Concetta, Cortesia Ilaria, Torta Francesca, Davitto Bava Mirella, Tardivo Irene, Spada Marco
Department of Pediatrics, University of Turin, 10126 Turin, Italy.
Department of Pediatrics, Regina Margherita Pediatric Hospital, 10126 Turin, Italy.
Children (Basel). 2024 Aug 29;11(9):1060. doi: 10.3390/children11091060.
Chorea is a neurological disorder characterized by random, fluid movements that may affect the limbs, trunk, neck, or face. In children, Sydenham's chorea (SC) is the most common cause of acute chorea, mainly following group A beta-hemolytic streptococcal (GABHS) infection. Other autoimmune and metabolic disorders may also cause chorea.
We report the case of a 6-year-old girl who developed chorea following cardiac surgery for mitral insufficiency. One week after discharge, the patient presented with right-sided hyposthenia, slower speech, mild dysarthria, and sialorrhea. Brain MRI and intracranial MRI angiography revealed a small vascular lesion consistent with a microembolic event. Extensive diagnostic investigations, including serum panels for autoimmune encephalitis, neurotropic viruses, and metabolic disorders, were negative.
Considering the patient's history, clinical course, and the exclusion of other potential causes, a diagnosis of post-pump chorea was made. This case underlines the importance of a thorough differential diagnosis in pediatric chorea and highlights post-pump chorea as a significant postoperative complication in pediatric cardiac surgery. The patient's motor symptoms improved with symptomatic treatment, and follow-up showed good recovery without neurological sequelae.
舞蹈症是一种神经系统疾病，其特征为随机、流畅的运动，可累及四肢、躯干、颈部或面部。在儿童中， Sydenham舞蹈症（SC）是急性舞蹈症最常见的病因，主要继发于A组β溶血性链球菌（GABHS）感染。其他自身免疫性和代谢性疾病也可能导致舞蹈症。
我们报告了一名6岁女孩的病例，该女孩在二尖瓣关闭不全心脏手术后出现舞蹈症。出院一周后，患者出现右侧肌无力、言语迟缓、轻度构音障碍和流涎。脑部MRI和颅内MRI血管造影显示一个小血管病变，符合微栓塞事件。包括自身免疫性脑炎、嗜神经病毒和代谢紊乱的血清检查在内的广泛诊断性检查均为阴性。
考虑到患者的病史、临床病程以及排除其他潜在病因，诊断为泵后舞蹈症。该病例强调了小儿舞蹈症全面鉴别诊断的重要性，并突出了泵后舞蹈症作为小儿心脏手术中一种重要的术后并发症。患者的运动症状经对症治疗后改善，随访显示恢复良好，无神经后遗症。
