Question
My niece’s daughter is over 5 years old and is very mischievous, doing and making a ruckus about everything, acting like a boy. But recently, she has been frowning for no apparent reason and even has twitches sometimes. I’m very worried. What should I do?
Answer
Childhood tic disorders mainly manifest as single-muscle, repetitive, involuntary twitching, with the facial muscles being most frequently involved. Sydenham’s chorea often involves multiple muscle groups, with varied movements, particularly large joint movements of the limbs. This can be accompanied by shrugging shoulders, flinging hands, squinting eyes, and twisted mouths. Symptoms can also include muscle weakness, relaxed limbs during passive movement, joint pain in the limbs, throat pain, palpitations, fever, and more.