Chorea

Medical specialist	Nerves
Symptoms	Repetitive, brief involuntary movements
risk factor	According to the cause
Cara diagnosis	Medical interview, physical examination, laboratory, imaging
Treatment	Adjusted for the cause
Drug	Adjusted for the cause
Complications	Adjusted for the cause
When to see a doctor?	There are changes in body movements, psychological disturbances

Understanding

Chorea is a disorder characterized by involuntary, repetitive, brief, irregular, and rather rapid movements.

Movement can start in one part of the body–appear suddenly, unpredictably, and often–and then move on to other parts.

This disorder is associated with rapid and uncoordinated movements, which generally occur in the face, hands, and feet.

Chorea disease is divided into two, namely:

• Primary (idiopathic, hereditary): tends to occur insidiously and is symmetrical
• Secondary (acquired): tends to be acute or subacute, and can be asymmetric or unilateral

Reason 

Chorea can be caused by various diseases, such as:

• AIDS
• Autoimmune diseases, such as  lupus/SLE (Systemic Lupus Erythematosus)
• Genetic diseases, such as  Huntington’s
• Infectious diseases, eg Sydenham’s chorea
• Medications, including neuroleptics and levodopa
• Metabolic disorders, eg hypoglycemia
• Pregnancy

Risk Factors

Chorea risk factors depend on the cause, including:

• Family history
• There is  a history of rheumatic fever

Symptoms

Symptoms of chorea are very diverse, ranging from symptoms that are relatively mild to symptoms that are quite severe. In mild cases, the condition may appear purposeful and difficult to distinguish from restlessness.

Chorea disease gives a common symptom, namely the characteristic clutches called milkmaids. Sufferers generally do not have strong hand muscles, so when they grip it they will release it.

This condition can affect various parts of the body and can interfere with speech, swallowing, posture, and movement. Symptoms usually worsen when sufferers experience anxiety and stress.

In addition, chorea symptoms can also be associated with other diseases, such as:

• Huntington’s disease

Chorea is usually experienced by Huntington’s sufferers which occur as adults. Over time, symptoms of unconscious jerking movements appear.

• Chorea-acanthocytosis

Chorea in this disease involves movement of the arms and legs.

For example, the movement of shrugging the shoulders, pushing the hips, and unconscious facial movements, such as grinding teeth, belching,  spitting, biting the tongue or lips, difficulty communicating, or slurred speech.

• Chorea Sydenham

Chorea in this disease usually involves the face and hands. Sufferers can have difficulty making conscious movements, making it difficult to wear clothes or eat.

Other symptoms include frequent dropping of things, abnormal gait, weak muscles, slurred speech, and loss of muscle tone.

Diagnosis 

Chorea is quite difficult to diagnose because there are several diseases that also have similar symptoms to chorea.

For this reason, the doctor must conduct a detailed medical interview, especially regarding the medical history and medication, which may be related to chorea.

Investigations will also be carried out, such as blood laboratory tests (thyroid hormone, blood sugar) and imaging (CT or MRI).

If the copper level is low, the patient may have  Wilson’s genetic disease which can cause chorea.

Treatment 

Chorea treatment depends on the type of disease. Unfortunately, no medication has been shown to slow or stop the development of hereditary forms of chorea, with the exception of copper-reducing therapy in Wilson’s disease.

Treatment aims to overcome associated diseases, for example:

• Huntington’s disease is treated with antipsychotics, such as  haloperidol,  risperidone, and others
• Sydenham was treated with antibiotics
• There is no cure for chorea due to Parkinson’s. However, the symptoms that appear can be controlled with drugs such as dopamine

Other drugs that can also be used are reserpine and tetrabenazine. These drugs can reduce levels of dopamine, benzodiazepines, and anticonvulsants.

Surgery by placing electrodes for brain stimulation also gives pretty good results.

The tool helps regulate nerve impulses in the brain. However, while these procedures can help, chorea cannot be cured.

Prevention 

How to prevent chorea depends on the cause. However, it is quite difficult to prevent chorea due to inherited diseases, such as Huntington’s disease.

Meanwhile, the chorea caused by rheumatic fever can be prevented with appropriate antibiotic treatment.

Complications 

Chorea complications depend on the cause. However, if the unconscious movement is severe enough, it can cause trauma.

In certain conditions that interfere with the eating process, it can cause weight loss, aspiration pneumonia, and even death.