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What is The clinical manifestation of Sydenham chorea includes all except and explain in detail?
Sydenham&;s chorea is characterized by the abrupt onset (sometimes within a few hours) of neurologic symptoms, classically chorea, usually affecting all four limbs. Other neurologic symptoms include behavior change, dystharia, gait disturbance, loss of fine and gross motor control with resultant deterioration of handwriting, headache, slowed cognition, facial grimacing, fidgetiness and hypotonia, Also, there may be tongue fasiculations ("bag of worms") and a "milk sign", which is a relapsing grip demonstrated by alternate increases and decreases in tension, as if hand milking. Chorea Dysahria Emotional Facial grimacing Generalized hypotonia Headache Hemiballismus Inappropriate behavior Irritability Movement abnormality of the tongue Obsessive-compulsive behavior Unsteady gait 5%-29% of people have these symptoms Endocarditis Erythema Recurrent streptococcus pneumoniae infections Septic ahritis Reference: GHAI Essential pediatrics, 8th edition