People with chorea may appear restless, fidgety, or dance-like due to brief, random, and unpredictable muscle contractions. Chorea can affect any part of the body, but it often affects the face, arms, and legs.
Chorea is not a disease by itself, but rather a symptom of various conditions that affect the brain. Some of the most common causes of chorea include:
Huntington's disease, a genetic disorder that causes progressive brain degeneration and movement problems.
Sydenham's chorea, a complication of rheumatic fever, an inflammatory disease that can follow a streptococcal infection.
Medication-induced chorea, a side effect of certain drugs that affect the brain, such as antipsychotics, levodopa, or oral contraceptives.
Metabolic or endocrine disorders, such as hyperthyroidism, hypoglycemia, or liver failure.
Autoimmune disorders, such as lupus, multiple sclerosis, or Sjogren syndrome.
Stroke, brain injury, infection, or tumor.
Symptoms of chorea include involuntary muscle movements that can vary in intensity, frequency, and duration. These movements can affect any part of the body, but they tend to affect the face, arms, and legs most frequently.
Fidgeting, twisting, or jerking of the limbs.
Grimacing, blinking, or tongue protrusion of the face.
Difficulty walking, swallowing, or speaking.
Milkmaid's grip, a repetitive gripping and releasing of the hand when trying to extend it.
Jack-in-the-box tongue, a rapid in-and-out movement of the tongue.
Chorea symptoms can intensify with stress, fatigue, or illness. They can also interfere with daily activities, such as eating, dressing, or writing. Chorea can also lead to emotional or psychological distress, such as anxiety, depression, or low self-confidence.
It is first necessary for a doctor to take a medical history and perform a physical examination to diagnose chorea. A doctor will ask about the onset, duration, and severity of the symptoms, as well as any possible triggers, such as medication, infection, or family history. As well as observing the movements, the doctor will look for other signs of neurological problems, such as muscle tone or reflexes.
The doctor may also order some tests to identify the underlying cause of chorea, such as:
Blood tests, to check for infection, inflammation, or metabolic or hormonal imbalances.
Genetic tests, to look for mutations that cause Huntington's disease or other inherited disorders.
Imaging tests, such as MRI or CT scan, to look for abnormalities in the brain, such as stroke, tumor, or infection.
Electroencephalogram (EEG), to measure the electrical activity of the brain and detect any seizures or abnormal rhythms.
A number of treatment options are available to patients suffering from chorea, depending on the cause and severity of the symptoms. The main goals of treatment are to reduce movements, improve quality of life, and treat the underlying cause.
A medication that suppresses the activity of brain chemicals (neurotransmitters) that control movement, such as dopamine, acetylcholine, or glutamate. Anticonvulsants, benzodiazepines, antipsychotics, and tetrabenazine can all be used to reduce chorea.
Physical therapy, to improve muscle strength, flexibility, balance, and coordination. Physical therapy can also help with pain, stiffness, or spasticity that may accompany chorea.
A physical therapist can help with muscle strength, flexibility, balance, and coordination, as well asprovide adaptive devices, such as splints, braces, or utensils, to make tasks easier and safer.
In addition to providing adaptive devices such as splints, braces, or utensils, occupational therapy can also assist in daily activities, such as eating, dressing, and writing..
A psychotherapist can help with emotional and psychological issues, such as anxiety, depression, and low self-esteem, in addition to providing support, education, and coping skills to deal with chorea's challenges.
The procedure, called deep brain stimulation (DBS), involves implanting a device that delivers electrical stimulation to specific areas of the brain responsible for movement.
Some causes of chorea, such as Huntington's disease or stroke, are not preventable. However, some steps that can help prevent or reduce the risk of chorea include:
Avoiding or limiting the use of drugs that may cause chorea, such as antipsychotics, levodopa, or oral contraceptives. If these medications are necessary, the doctor will adjust the dose or prescribe alternatives.
Antibiotics can be used to treat or prevent infections that can cause rheumatic fever, such as strep throat or scarlet fever.
Whenever possible, avoid or limit the use of drugs that candisorders, such as hyperthyroidism, hypoglycemia, or liver failure. This can be done by following a healthy diet, taking medication as prescribed, and monitoring blood levels regularly.
Following a healthy diet, taking medication as prescribed, and monitoring blood levels regularly can help control or prevent metabolic or endocrine disorders, such as hyperthyroidism, hypoglycemia, or liver failure.ical attention for any symptoms of neurological problems.
ChAvoiding strokes, brain injuries, infections, or tumors. Controlling blood pressure, cholesterol, and blood sugar, quitting smoking, limiting alcohol consumption, wearing a seat belt or helmet, and seeking medical attention if you experience neurological problems are ways to accomplish thisistory, physical examination, and tests. In addition to medication, physical therapy, occupational therapy, speech therapy, psychotherapy, and surgery can be used to treat Chorea, depending on its cause and severity. Chorea can be prevented or reduced by avoiding or treating the factors that can trigger it, such as infection, medication, or metabolic disorder.
