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He however noted that, unlike in Rheumatic Chorea, the tendon reflexes were brisk.
The defendant examined the child and observed involuntary movements of the upper limbs based on which she made a diagnosis of Rheumatic Chorea and admitted the child to hospital for further management.
Prof. Lamabadusuriya initially concurred with the diagnosis of Rheumatic Chorea, making an entry in the Bed Head Ticket- "All features of Rheumatic Chorea Seen".
With limited clinical experience, involving typically one or two patients, authors advanced different ideas, including brain lesions similar to those resulting from rheumatic chorea or encephalitis lethargica as a cause of tics, faulty mechanisms of normal habit formation, and treatment with Freudian psychoanalysis.