Chorea: Causes, Symptoms, and Treatment
Medically reviewed by Sumiran Racherla, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Chorea?
A neurologist, a doctor who treats diseases of the brain and nerves, usually evaluates chorea and helps find what is causing it. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What are chorea movements?
Chorea is a movement disorder that causes irregular, purposeless movements you cannot control. The movements seem to flow from one body part to another. They can affect any part of the body. In Huntington disease, the movements are often called dance-like.
Chorea is not one single disease. Many different conditions can cause it.
Symptoms
The main symptom is movement you cannot control. Two common causes are Sydenham chorea and Huntington disease.
- In Sydenham chorea, the movements are jerky and affect the hands, arms, shoulders, face, legs, and trunk.
- In Sydenham chorea, the twitch-like movements go away during sleep.
- Sydenham chorea can also change handwriting and cause loss of fine control of the fingers and hands.
- Sydenham chorea can cause bouts of crying or laughing at the wrong time.
- In Huntington disease, chorea can get worse over time or when the person is nervous or distracted.
- Huntington disease can also cause clumsiness, balance problems, trouble walking, and slurred speech.
Causes and who gets it
Causes are hereditary (passed down in genes) or acquired (not passed down in genes). Main acquired causes are infections, autoimmune disorders, metabolic problems, blood vessel problems, and medicines. The most common cause of sudden chorea in childhood is Sydenham chorea. The most common cause of slowly worsening chorea in adults is Huntington disease.
Sydenham chorea is caused by an infection with group A streptococcus bacteria. These germs also cause strep throat and rheumatic fever. The germs can trigger an immune reaction against part of the brain. It occurs most often in girls before puberty, but boys can get it too.
Huntington disease is an inherited disorder. Nerve cells in parts of the brain slowly break down and die. When a parent has HD, each child has a 50% chance of inheriting the genetic variant.
Some medicines can cause chorea, including levodopa, a medicine used for Parkinson disease. Chorea can also be seen with birth control pills. Other rare causes include an overactive thyroid, lupus, and pregnancy.
How doctors diagnose it
The first step is to recognize the movement disorder as chorea. Doctors then ask when it began and whether it runs in the family. They look for Sydenham chorea in children and Huntington disease in adults first.
For Sydenham chorea, tests may include a throat swab and blood tests to look for a strep infection. A doctor may also order an MRI or CT scan of the brain.
Doctors diagnose Huntington disease using symptoms, tests, brain imaging, family history, and genetic testing. Genetic testing is the best way to confirm it. Brain scans may show changes, but people with early Huntington disease may have normal scans.
Treatment
Chorea caused by another condition may be treatable. So doctors work to find the cause.
For Sydenham chorea, antibiotics are used to kill the strep bacteria. A doctor may also prescribe antibiotics to prevent future rheumatic fever. Severe movement or emotional symptoms may need medicines. Sydenham chorea usually clears up in a few months.
For chorea from an overactive thyroid, treatment focuses on bringing thyroid function back to normal.
The NIH says there is no treatment that can stop or reverse Huntington disease, but some symptoms can be treated. Researchers are looking for new treatments. The medicines tetrabenazine and valbenazine are used to treat chorea symptoms in Huntington disease. Side effects of medicines used to treat the symptoms of Huntington disease may include tiredness, sleepiness, trouble concentrating, restlessness, or increased activity. Some antipsychotic medicines can make movement symptoms worse in people with Huntington disease, so doctors watch for side effects.
When to see a doctor
Contact a doctor if your child has uncontrollable or jerky movements, especially after a recent sore throat. Call 911 or go to the emergency room for trouble breathing, a seizure, fainting, sudden weakness, or confusion. Huntington disease can cause thoughts of suicide or severe depression. If you are thinking about harming yourself, call or text 988 (the Suicide and Crisis Lifeline) right away.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either type of doctor can listen to your symptoms, review your medicines, and arrange tests to look for a cause. They can also refer you to a neurologist and help coordinate your care over time.
Common questions
Is chorea a disease?
No, chorea is a type of movement disorder that many different conditions can cause.
Does Sydenham chorea go away?
Yes, Sydenham chorea usually clears up in a few months. Antibiotics are used to kill the strep bacteria that cause it.
Is Huntington disease the only cause of chorea?
No, many conditions can cause chorea. Huntington disease is the most common cause of slowly worsening chorea in adults. Other causes include Sydenham chorea, some medicines, and an overactive thyroid.
Can medicines cause chorea?
Yes, some medicines can cause chorea. Examples include levodopa and birth control pills.
Sources
- National Library of Medicine (PMC) - Review of Hereditary and Acquired Rare Choreas
- National Institute of Neurological Disorders and Stroke - Huntington's Disease
- MedlinePlus - Sydenham chorea
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
