What is chorea?
Chorea is a movement disorder that causes involuntary,
unpredictable body movements. Chorea symptoms can range from minor movements,
such as fidgeting, to severe uncontrolled movements of the arms and legs. It
can also interfere with speech, swallowing, posture, and gait.
What are the symptoms of chorea?
Chorea symptoms usually depend upon the condition causing
it. A common symptom is “milkmaid’s grip.” People
with this condition don’t have strong hand muscles and will squeeze and release
their hand, as if milking. Another symptom is involuntarily sticking out the
Chorea movements can be fast or slow. A person may appear to
be writhing in pain and have no bodily control.
Conditions associated with chorea and its symptoms include:
Huntington’s disease is an inherited disease. It causes the
breakdown of nerve cells in your brain. People with Huntington’s
disease can experience chorea symptoms such as involuntary jerking or writhing.
grip is also a common symptom. Chorea is more common in people with adult-onset
disease. Over time, symptoms may get worse and movements may affect the legs
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, and 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
- teeth grinding
- involuntary belching
- drooling or spitting
- lip and tongue biting
- difficulty with speech or communication
- vocal tics, such as grunting, involuntary speaking, or
This condition mainly affects children and adolescents, and
follows a streptococcal infection. It can also be a complication of rheumatic
fever. This type of chorea mainly affects the face, arms, and hands. It can
impede voluntary movements, making it difficult to perform basic tasks such as
getting dressed or feeding yourself.
It can also lead to:
- frequently dropping or spilling items
- abnormal gait
- muscle weakness
- slurred speech
- diminished muscle tone
People with this chorea type often display milkmaid grip. Another
common symptom is called “harlequin tongue.”
When a person with this symptom tries to stick their tongue out, the
tongue pops in and out instead.
What are risk factors for chorea?
People with a history of rheumatic fever are more likely to
experience chorea. This risk factor makes pregnant women more likely to have
Other risk factors are related to risks for a specific
disease. For example, Huntington’s disease is a hereditary disorder that may cause
chorea. A person with a parent who has Huntington’s disease has a 50 percent
risk of inheriting the disease, according to the Mayo Clinic.
What causes chorea?
Chorea is associated with a number of additional causes,
some temporary and some chronic. These causes include:
- genetic conditions, such as Huntington’s disease
- immune conditions, such as systemic lupus erythematosus
- infection-related conditions, such as Sydenham’s chorea
- medications, including levodopa and neuroleptics
- metabolic or endocrine disorders, including
- pregnancy, known as chorea gravidarum
How is chorea diagnosed?
Because many conditions cause chorea, your doctor must take
a thorough medical history to determine potential causes. To diagnose chorea,
your doctor may ask:
- When did the symptoms begin?
makes the symptoms better or worse? Do your chorea symptoms tend to worsen when
you have a family history of hyperthyroidism or Huntington’s disease?
medications are you taking?
Some laboratory tests can indicate chorea. For example, a
low copper level in your body can indicate Wilson disease, a genetic disorder
that causes chorea. Tests for spiky erythrocytes or red blood cells can
indicate chorea-acanthocytosis. Blood tests for parathyroid hormones or thyroid
hormones can indicate metabolic or endocrine-related chorea.
For Huntington’s disease, imaging studies, such as MRI scans, can
show brain activity to indicate the disease.
How is chorea treated?
Treatment of chorea depends on the type of chorea you have. It
aims to treat the underlying condition, which will help with chorea symptoms.
For example, Sydenham’s
chorea may be treatable with antibiotics. Huntington’s disease chorea can be
treated with antipsychotic drugs, as well as other medications. Chorea due to
disease has no cure but symptoms can be controlled.
Most medications for chorea affect dopamine. Dopamine is a
neurotransmitter, or brain chemical, that controls movement, thinking, and
pleasure in your brain, among other things. Many movement disorders are
associated with dopamine levels. These disorders include Parkinson’s
disease and restless legs syndrome.
Some medications block dopamine receptors so your body can’t
use the chemical. Many of these are antipsychotic drugs that seem to reduce
chorea. These drugs include:
Other drugs reduce the amount of
dopamine in the brain, such as reserpine and tetrabenazine (Xenazine). Medications known as benzodiazepines, such as clonazepam (Klonopin), may also help to reduce chorea.
Anticonvulsants, which reduce
spontaneous movements, can also reduce chorea symptoms.
Deep brain stimulation is a surgical approach that shows
promise for chorea treatment. This treatment involves implanting electrodes in
your brain to regulate nerve impulses. If chorea doesn’t respond to
medications, your doctor may recommend deep brain stimulation. This procedure
does not cure chorea but can reduce its symptoms.
Chorea increases a person’s likelihood for falls. Home
care measures include installing non-slip surfaces on stairs and in bathrooms
to prevent injury. Talk to your doctor about other ways to modify your home for
What is the outlook for chorea?
The outlook for chorea depends on the condition causing it.
Antibiotics can cure Sydenham’s chorea, while there is no cure for Huntington’s
disease. Women with chorea gravidarum typically stop having symptoms within six
weeks after giving birth. People with metabolic or endocrine-related chorea
typically stop having symptoms once a doctor treats the imbalance. Whatever the
condition causing chorea, your doctor will develop a treatment plan to help you
manage and control your symptoms.