Chorea and related disorders
- 1Department of Neurology, UCLA Medical Center, David Geffen UCLA School of Medicine and Parkinson’s Disease Research, Education and Clinical Center (PADRECC) of West Los Angeles Veterans Affairs Medical Center, Los Angeles, California, USA
- 2Parkinson’s and Movement Disorder Institute, Fountain Valley, California, USA
- Correspondence to: Dr Daniel D Truong Parkinson’s and Movement Disorders Institute, 9940 Talbert Avenue, #204, Fountain Valley, CA 92708, USA; dtruongpmdi.org
- Received 17 January 2004
- Accepted 24 February 2004
Abstract
Chorea refers to irregular, flowing, non-stereotyped, random, involuntary movements that often possess a writhing quality referred to as choreoathetosis. When mild, chorea can be difficult to differentiate from restlessness. When chorea is proximal and of large amplitude, it is called ballism. Chorea is usually worsened by anxiety and stress and subsides during sleep. Most patients attempt to disguise chorea by incorporating it into a purposeful activity. Whereas ballism is most often encountered as hemiballism due to contralateral structural lesions of the subthalamic nucleus and/or its afferent or efferent projections, chorea may be the expression of a wide range of disorders, including metabolic, infectious, inflammatory, vascular, and neurodegenerative, as well as drug induced syndromes. In clinical practice, Sydenham’s chorea is the most common form of childhood chorea, whereas Huntington’s disease and drug induced chorea account for the majority of adult onset cases. The aim of this review is to provide an up to date discussion of this disorder, as well as a practical approach to its management.
- DRPLA, dentatorubralpallodoluysian atrophy
- KF rings, Kayser-Fleischer rings
- MRI, magnetic resonance imaging
- SLE, systemic lupus erythematosus
- SSRIs, selective serotonin reuptake inhibitors
