Chorea
Chorea is a movement disorder characterized by involuntary, irregular, unpredictable, and non-repetitive movements that flow from one body part to another, resembling a dance-like pattern. The word "chorea" comes from the Greek word for dance. It can affect the face, trunk, and limbs and may significantly interfere with daily activities, speech, and swallowing.
What is Chorea?
Chorea arises from dysfunction of the basal ganglia — the brain regions that regulate and coordinate smooth, voluntary movement. It can be a symptom of an underlying genetic condition, an autoimmune disorder, a metabolic disturbance, or a medication side effect. Accurate diagnosis is essential to target the underlying cause.
Common Symptoms
- Involuntary, jerky, flowing movements of limbs, face, or trunk
- Writhing movements (when severe, termed choreoathetosis)
- Difficulty maintaining a steady grip ("milkmaid's grip")
- Facial grimacing or tongue movements
- Slurred or irregular speech
- Gait disturbance ("dancing gait")
- Difficulty swallowing
- Behavioral or psychiatric symptoms (in Huntington's disease)
Common Causes of Chorea
Huntington's Disease
A hereditary neurodegenerative disorder causing progressive chorea, cognitive decline, and psychiatric symptoms.
Sydenham's Chorea
An autoimmune complication of rheumatic fever following streptococcal infection, most common in children.
Drug-Induced Chorea
Caused by dopaminergic medications, antipsychotics (tardive dyskinesia), or oral contraceptives.
Metabolic and Systemic Causes
Thyroid disease, liver failure, lupus (SLE), polycythemia vera, and pregnancy (chorea gravidarum).
Diagnosis
- Detailed neurological examination
- Genetic testing (Huntington's disease gene mutation)
- MRI Brain (caudate atrophy in Huntington's)
- Blood tests (ASO titre, thyroid, metabolic panel, autoimmune screen)
- Medication and drug history review
- Neuropsychological assessment
Treatment Options
- Dopamine-depleting agents (tetrabenazine, deutetrabenazine) for Huntington's chorea
- Antipsychotics (haloperidol, clonazepam) for symptomatic control
- Immunotherapy for autoimmune chorea
- Penicillin prophylaxis for Sydenham's chorea
- Withdrawal of offending drugs
- Physiotherapy, occupational therapy, speech therapy
- Genetic counseling for Huntington's disease
When Should You See a Neurologist?
- Involuntary, uncontrollable movements
- Family history of Huntington's disease
- New abnormal movements following streptococcal infection
- Chorea with psychiatric or cognitive symptoms
- Involuntary movements appearing after starting a new medication
Why Choose Us?
- Experienced Consultant Neurologist specializing in Movement Disorders
- Accurate Diagnosis including Genetic & Autoimmune Workup
- Personalized Treatment Plans
- Evidence-Based Neurological Care
- Compassionate Patient & Family-Centered Approach
- Comprehensive Follow-Up Care