Chorea (disease)

Chorea (disease) Classification and external resources
ICD-10	G 25.5
ICD-9	333.5
DiseasesDB	16662
eMedicine	neuro/62
MeSH	D002819

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, see chorea), as the quick movements of the feet or hands are vaguely comparable to dancing or piano playing.

1 Presentation
2 Causes
3 Ballism
4 Treatment
5 See also

Presentation

Chorea is characterized by brief, quasi purposive, 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. Lumps called nodules may also form under the skin in bony areas.

Causes

Chorea can occur in a variety of conditions and disorders.

Chorea is a primary feature of Huntington's disease, a progressive, hereditary movement disorder.
Twenty percent of children and adolescents with rheumatic fever develop Sydenham's chorea as a complication.
Chorea may also be caused by drugs (levodopa, anti-convulsants, anti-psychotics), metabolic disorders, endocrine disorders, and vascular incidents.

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.

Treatment

There is no standard course of treatment for chorea. Treatment depends on the type of chorea and the associated disease.

Although there are many drugs that can control Chorea, there is no known cure.

Cause	Treatment
Huntington's disease	A common treatment is dopaminergic antagonists, although treatment is largely supportive.
Sydenham's chorea	Haloperidol, carbamazepine and valproic acid.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.

Inflammatory	Meningitis (Arachnoiditis, Aseptic meningitis, Tuberculous meningitis, Pneumococcal meningitis) · Encephalitis · Myelitis · Encephalomyelitis (Acute disseminated) · Tropical spastic paraparesis · Cavernous sinus thrombosis

Systemic atrophies	Huntington's disease · Spinocerebellar ataxia (Friedreich's ataxia, Ataxia telangiectasia, Hereditary spastic paraplegia) · Spinal muscular atrophy: Werdnig-Hoffman · Kugelberg-Welander · Fazio-Londe · MND (ALS, PMA, PBP, PP, PLS)

Extrapyramidal and movement disorders	Parkinson's disease · Neuroleptic malignant syndrome · Postencephalitic parkinsonism · Pantothenate kinase-associated neurodegeneration · Progressive supranuclear palsy · Striatonigral degeneration · Dystonia/Dyskinesia (Spasmodic torticollis, Meige's, Blepharospasm) · Essential tremor · Myoclonus · Lafora · Chorea (Choreoathetosis) · Restless legs · Stiff person

Dementia	Alzheimer's · Pick's · Dementia with Lewy bodies · Frontotemporal lobar degeneration

Mitochondrial disease	Leigh's

Demyelinating disease	Multiple sclerosis · Devic's · Central pontine myelinolysis · Transverse myelitis · Marchiafava-Bignami disease · CAMFAK syndrome · Alpers'