Choreia (disease)

Choreia (disease)
Choreia (disease)
Classification and external resources
ICD-10 G25.5
ICD-9 333.5
DiseasesDB 16662
eMedicine neuro/62
MeSH D002819

Choreia (or chorea) is an abnormal involuntary movement disorder, one of a group of neurological disorders called dyskinesias. The term choreia is derived from the Greek word χορεία (=dance), see choreia (dance), as the quick movements of the feet or hands are vaguely comparable to dancing or piano playing.

The term hemichoreia refers to choreia of one side of the body, such as choreia of one arm and not both (comparable to hemiballismus).

Contents

Presentation

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

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

Causes

Choreia can occur in a variety of conditions and disorders.

  • Choreia is a primary feature of Huntington's disease, a progressive neurological disorder.
  • Twenty percent (20%) of children and adolescents with rheumatic fever develop Sydenham's chorea as a complication.
  • Choreia gravidarum is rare type of choreia which is a complication of pregnancy.
  • Choreia may also be caused by drugs (levodopa, anti-convulsants, anti-psychotics), metabolic disorders, endocrine disorders, and vascular incidents.
  • Ataxia telangiectasia
  • Wilson's disease, a genetic disorder that leads to toxic levels of copper in the body
  • McLeod syndrome, a genetic disorder that may affect the blood, brain, peripheral nerves, muscle and heart. Common features include peripheral neuropathy, cardiomyopathy and hemolytic anemia. Other features include limb chorea, facial tics, other oral movements (lip and tongue biting), seizures, a late-onset dementia and behavioral changes.

Ballism

When choreia is serious, slight movements will become thrashing motions; this form of severe choreia 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 choreia and ballism occur on their own, without conscious effort.

Treatment

There is no standard course of treatment for choreia. Treatment depends on the type of choreia and the associated disease. Although there are many drugs that can control it, no cure has yet been identified.

Form Treatment
Huntington's-related 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.
Choreia gravidarum haloperidol,[1][2][3] chlorpromazine alone or in combination with diazepam, also pimozide can also be used.
Wilson's disease Reducing levels of copper in the body using D-penicillinamine, trientine hydrochloride, tetrathiomolybdate, and other chelating agents
Drug-induced choreia Adjusting medication dosages.
Metabolic and endocrine-related choreias Treated according to their causes.

See also

References

  1. ^ Axley J (December 1972). "Rheumatic choreia controlled with haloperidol". The Journal of Pediatrics 81 (6): 1216–7. doi:10.1016/S0022-3476(72)80272-5. PMID 4643046. 
  2. ^ Patterson JF (September 1979). "Treatment of choreia gravidarum with haloperidol". Southern Medical Journal 72 (9): 1220–1. doi:10.1097/00007611-197909000-00044. PMID 472859. http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0038-4348&volume=72&issue=9&spage=1220. 
  3. ^ Donaldson JO (March 1982). "Control of choreia gravidarum with haloperidol". Obstetrics and Gynecology 59 (3): 381–2. PMID 7078886. 

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