Chorea
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Web Resources for Chorea
Relevant Clinical Literature
RCT with Chorea from Pubmed
UK Guidance
Other Wikis
Medpedia on Chorea (Less technical, good quality control)
Wikipedia on Chorea (Less technical, ? quality control)
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Chorea derives from the Greek word khoros, meaning danceContents |
Description
Chorea is characterised by irregular, involuntary movements, particularly of the distal limb musculature.
In its mildest form, choreiform movement can be integrated into voluntary movement, and its appearance can therefore be disguised. However, gross changes of limb or body position are seen in the more severe forms.
Differentials
Any disease that can affect basal ganglia:
- Hereditary diseases:
- Infective:
- Autoimmune
- Vascular:
- Stroke particularly of basal ganglia
- Vasculitis
- Subdural haematoma
- A-V malformations
- Metabolic:
- Renal failure
- Vitamin deficiencies
- Hypoparathyroidism
- Haemochromatosis
- Polycythemia
- Neoplasia:
- Paraneoplastic syndrome
- Metastases to basal ganglia
- Drugs:
- Toxins:
- Unknown
- Senile chorea (care - in one study almost 50% had late onset Huntington's chorea and less than 10% so labeled were unexplained on appropriate testing)[1]
Investigations
Directed towards suspected cause based on history and examination
Therapy
- Antipsychotics - block dopamine receptors e.g. haloperidol
- Dopamine depleting agents - tetrabenazine
- Benzodiazepines
- Anticonvulsants
