2023-04-25 00:30:40
Chorea itself is not a disease, but rather refers to involuntary and sudden movements that cannot be controlled. We explain what are the diseases associated with its appearance.
The word ‘chorea’ is used to describe a neurological symptom that accompanies certain diseases. This term comes from the Greek chorea which translates as ‘dance’. It is defined as a sudden, involuntary and short-term movement in some part of the body.
It usually affects the hands or face; for example, it is when a person moves his hand unconsciously, as if he were going to hit something. Being something that you cannot control, this tends to affect the quality of life of those who suffer from it.
In itself, it is a condition associated with diseases such as rheumatic fever or Huntington’s disease, although they are not its only causes. In this article We explain everything you need to know about chorea and why it occurs.
What is chorea?
Chorea is the medical term used to refer to rapid, involuntary and sudden movements that usually occur in the distal portion of the extremities or on the face. However, the trunk can also be affected.
As explained in a post on National Institute of Neurological Disorders and Stroke, movements in this condition are unpredictable. They change from one area of the body to another, without following any sequence.
Typically, it appears as a consequence of lesions in certain brain areas, such as the caudate nucleus or the putamen. It is not a disease, but a clinical manifestation or symptom of other health disorders. Therefore, in itself it is not considered a danger to life.
In any case, as it usually occurs in the context of other pathologies, these can indeed constitute a risk. Thus, depending on its cause, chorea may or may not be temporary. Sometimes it persists and gets progressively worse.
For example, this is what happens in Huntington’s disease. It can also be accompanied by two other characteristic movements.
- First of all, it may be related to the ‘ballistic’. This term refers to more intense movements, such as the throw of an arm in a sharp and concise way.
- It can also be related to ‘athetosis’. In this case, what appears are slow movements, also uncontrollable. These resemble sustained twisting of the hands or limbs.
symptoms of chorea
Chorea usually produces involuntary movements of the extremities. It is also common for spasms to appear in them. Since there is no pattern and it is unpredictable, these occur in different places in the body.
According to a publication from the Navarra University Clinic, at the beginning of the symptoms people only experience nervous tics or excessive agitation. However, as the painting progresses, the movements become more intense and marked.
For this reason, jerks of the head, extremities or neck appear. These movements can interfere with the person’s daily life. This is because they tend to cause difficulties with speaking, relating, walking or eating.
Besides, the mood is also deteriorating. Chorea usually produces sudden mood swings. It is common for a person with this condition to be listless, irritable, depressed, or aggressive. Cognitive functions are progressively altered. Hence, memory or thought may be affected.
Related diseases
Chorea can appear against the background of numerous pathologies. They are usually classified according to whether they are acquired or hereditary. Within hereditary, the main cause is Huntington’s disease.
This represents a genetic disorder that It is inherited in an autosomal dominant manner. That is, only one copy of the defective gene is needed for the disease to appear. In this, chorea is often accompanied by personality disorders and problems with speech.
Symptoms progressively worsen and, on average, patients have a life expectancy of between 10 and 30 years when manifestations appear. Unfortunately, there is no cure for Huntington’s disease.
Chorea can also appear as a complication of rheumatic fever.. This, in turn, is a complication derived from a bacterial infection (group A streptococcus). It is common in children who have had strep throat.
There are other infections that can be associated, such as syphilis, Lyme disease or toxoplasmosis. Autoimmune diseases, such as systemic lupus erythematosus, can also cause it. The same happens with multiple sclerosis or sarcoidosis.
Finally, endocrine disorders should be highlighted. The most associated cases of chorea are hypoglycemia, hyperglycemia, thyroid problems and hypocalcemia.
Causes and risk factors of chorea
Chorea is often a symptom of another disorder. According to an article from the Cleveland Clinic, an estimated 30,000 people in the United States alone suffer from Huntington’s disease. On the other hand, approximately 4,000 cases of Sydenham’s chorea occur each year.
Its incidence itself is unknown. However, cerebral vascular lesions are one of its most important causes. That explains why approximately Some 56 patients out of 1,500 who have suffered a stroke end up developing it.
In order to distinguish the cause of this disorder, it is convenient to look at whether it presents acutely or progressively. Cases with an acute onset are usually caused by a poison or a drug. For example, levodopa to treat Parkinson’s or neuroleptics.
However, as we have already mentioned, its most typical progressive forms are due to Huntington’s disease and rheumatic fever.
Risk factor’s
There are certain factors that increase the risk of chorea. It is a condition that can appear at any age. However, it is more typical in elderly patients and children.
In the elderly it can appear without any apparent cause. For their part, children are more likely to have rheumatic fever, which is why they are the ones who usually suffer from Sydenham’s chorea.
As you age, there is also an increased risk of cardiovascular events. Strokes are related to chorea. The same occurs with tumors located near the basal ganglia of the brain.
One of the biggest risk factors It’s the family history. Specifically, having a relative who suffers from Huntington’s disease. Pregnancy is another risk situation, although it is much less frequent and is usually self-limiting.
Being under certain medical treatments can increase the probability of suffering from this disorder. We previously mentioned that it is associated with levodopa and neuroleptics. Other drugs may be anticonvulsants, antihistamines, or certain antidepressants.
How can it be diagnosed?
The diagnosis of chorea can be complex, especially finding out what the underlying cause of the condition is. The suspicion is usually made through the clinic, when observing uncontrollable and inexplicable nervous tics.
It is essential that the doctor knows the patient’s medical history, his history, if he has suffered from any infection, if there are other symptoms, etc. In addition, certain complementary tests are usually performed to guide the diagnosis.
- First of all, a full blood test is recommended. Through this test it is possible to detect infections and hormonal or metabolic alterations. It is also used to look for antibodies in the case of suspected autoimmune diseases.
- Imaging tests can also help. Magnetic resonance and computed tomography are used when it is suspected that there is a lesion at the brain level. For example, a stroke.
- Finally, genetic analysis can be performed to determine if it is caused by Huntington’s disease.
Available Treatments for Chorea
Chorea is treated depending on the cause that causes it. As explained in an article by Salud Canales Mapfre, Huntington’s disease has no treatment. There are only measures that can help alleviate some of the symptoms, but there is no cure.
For example, dopamine antagonists are used to try to reduce movements. If psychiatric disorders appear, the use of neuroleptics, antidepressants or anxiolytics can be recommended.
In general, most cases of chorea are treated with these drugs. Benzodiazepines are usually the most used anxiolytics. Tetrabenazine and reserpine are also used. They help reduce catecholamines.
If the cause is a metabolic disorder, it is essential to correct it. Sydenham’s chorea is usually self-limiting. The movements are also treated with dopamine antagonists. For the condition itself, antibiotics such as penicillin are prescribed, which can eliminate the infection.
What you must remember
Chorea itself is not a disease, but can occur in the context of many disorders. Many people tend to use this term as a synonym for Huntington’s disease. However, as we have seen, It can be a symptom of infections, metabolic disorders, autoimmune diseases, etc.
This symptom can seriously interfere with the life of the sufferer. Therefore, it is essential to try to find the cause quickly and establish the best treatment in each case.
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