Chorea

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Chorea
ICD-10 G25.5
ICD-9 333.5
DiseasesDB 16662
eMedicine neuro/62 
MeSH D002819

Template:Search infobox Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Overview

Chorea sancti viti (Latin for "St. Vitus' dance") is an abnormal involuntary movement disorder, one of a group of neurological disorders called dyskinesias. The term chorea is derived from a Greek word χορεία (a kind of dance), as the quick movements of the feet or hands are vaguely comparable to dancing or piano playing.

Presentation

Chorea is characterized by brief, irregular contractions that are not repetitive or rhythmic, but appear to flow from one muscle to the next.

These 'dance-like' movements of chorea (from the same root word as "choreography") often occur with athetosis, which adds twisting and writhing movements.

Causes

Chorea can occur in a variety of conditions and disorders.

Ballism

When chorea is serious, slight movements will become thrashing motions; this form of severe chorea is referred to as ballism. Walking may become peculiar, and include odd postures and leg movements. Unlike ataxia and dystonia, which affect the quality of voluntary movements or parkinsonism, which is a hindrance of voluntary movements, the movements of chorea and ballism occur on their own, without conscious effort.

Complete List of Differential Diagnoses

In alphabetical order. [1] [2]

Diagnosis

History and Symptoms

  • Complete history required
  • Psychiatric symptoms (Huntington's)

Appearance of the Patient

Eyes

Laboratory Findings

MRI and CT

Echocardiography or Ultrasound

  • In order to diagnose carditis, an ECG may be indicated

Other Imaging Findings

  • In order to reveal cerebral and cerebellar atrophies in patients with DRPLA, various imaging studies are indicated

Other Diagnostic Studies

Treatment

Cause Treatment
Huntington's disease A common treatment is dopaminergic antagonists, although treatment is largely supportive.
Sydenham's chorea Usually involves antibiotic drugs to treat the infection, followed by drug therapy to prevent recurrence.
Drug-induced chorea. Adjusting medication dosages.
Metabolic and endocrine-related choreas Treated according to the cause(s) of symptoms.

Acute Pharmacotherapies

References

  1. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
  2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X

See also

Template:Diseases of the nervous system Template:SIB


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