Chorea

Chorea symptoms usually depend upon the condition causing it. A common symptom is “milkmaid’s grip.” People with this condition don’t have coordinated hand muscles and will squeeze and release their hand, as if milking. Another symptom is involuntarily sticking out the tongue. Chorea movements can be fast or slow. A person may appear to be writhing in pain and have no bodily control. These movements have also been called dance-like or similar to piano playing. Conditions associated with chorea and its symptoms include: Huntington’s disease Chorea is more common in people with adult-onset Huntington’s disease. Over time, symptoms may get worse, and movements may affect the legs and arms. Chorea-acanthocytosis This condition is a very rare genetic disorder. It’s characterized by misshapen red blood cells. It causes neurological abnormalities and affects brain functioning. Chorea for this condition commonly involves: • abnormal arm and leg movements • shoulder shrugs • pelvic thrusts It can also involve rapid, purposeless movements of the face. People with this form of chorea can also exhibit dystonia. This is characterized by involuntary muscle contractions of the mouth and face, such as: • • involuntary • • lip and tongue biting • difficulty with speech or communication • difficulty swallowing • vocal tics, such as grunting, involuntary speaking, or slurred speech In addition to chorea and dystonia, this condition may cause: • seizures • neuropathy • loss of sensation • mus...

Contents • • • • • • • • • • • • • • • • • • • • • • • • • What is chorea Chorea is a random-appearing, continuous (while awake), abnormal involuntary movement disorder, which can affect the entire body. Chorea often includes the face and tongue. Symptoms in arms and legs are often worse on one side of the body. Chorea is classed as one of a group of neurological disorders called dyskinesias, which are caused by overactivity of the neurotransmitter dopamine in the areas of the brain that control movement 1) . Chorea is characterized by brief, irregular contractions that are not repetitive or rhythmic, but appear to flow from one muscle to the next. Chorea often occurs with athetosis, which adds twisting and writhing movements. Chorea is a primary feature of Huntington’s disease, a progressive, hereditary movement disorder that appears in adults, but it may also occur in a variety of other conditions. Sydenham’s chorea occurs in a small percentage (20 percent) of children and adolescents as a complication of rheumatic fever 2) . Chorea can also be induced by drugs (levodopa, anti-convulsants, and anti-psychotics) metabolic and endocrine disorders, and vascular incidents. Chorea can be due to a multitude of disorders with a wide variety of pathophysiologies. In addition to metabolic and structural causes, the list of potential investigations continues to grow as more potentially causative genes are discovered. Although treatments for genetic causes are not yet possible, corr...

Chorea is a nonrhythmic, jerky, rapid, nonsuppressible involuntary movement, mostly of the distal muscles and face; movements may be incorporated into semipurposeful acts that mask the involuntary movements. Athetosis (slow chorea) is nonrhythmic, slow, writhing, sinuous movements predominantly in distal muscles, often alternating with postures of the proximal limbs. Hemiballismus is unilateral rapid, nonrhythmic, nonsuppressible, wildly flinging movement of the proximal arm and/or leg; rarely, such movement occurs bilaterally (ballismus). Hemiballismus may be considered a severe form of chorea. Chorea and athetosis are defined by clinical manifestations; many experts believe that when they occur together (as choreoathetosis), athetosis is a dystonia superimposed on chorea. Chorea and athetosis result from impaired inhibition of thalamocortical neurons by the basal ganglia. Excess dopaminergic activity may be the mechanism. Huntington Disease Huntington disease is an autosomal dominant disorder characterized by chorea, neuropsychiatric symptoms, and progressive cognitive deterioration, usually beginning during middle age. Diagnosis... read more is the most common degenerative disorder causing chorea. In Huntington disease, drugs that suppress dopaminergic activity, such as Antipsychotic Drugs Antipsychotic drugs are divided into conventional antipsychotics and 2nd-generation antipsychotics (SGAs) based on their specific neurotransmitter receptor affinity and activity. SGAs...