A 15-year-old girl presents with fidgeting, writhing and twitching movements of the left side of her body. The fits appear to move in a random pattern. The movements are involuntary however, they get worse when she is anxious. She has stopped participating in school events due to embarrassment by the movements. There was no history of neuroleptic drug use. Despite stopping the intake of the oral contraceptive pill, her abnormal movements persisted. Medical History She is an asthmatic patient and uses salbutamol inhaler.
She suffered from a severe throat infection a few months ago. Her movements were described as choreiform. Blood tests, thyroid function tests and blood tests for SLE were all normal. Erythrocyte sedimentation rate and reactive protein were normal but her antistreptolysin O titer was significantly elevated. Her ECG and echocardiogram were normal. What is the diagnosis?…
