The word ‘chorea’ is used to explain a neurological symptom that accompanies certain diseases. This term comes from the Greek chorea which translates as ‘dance’. It’s defined as a sudden, involuntary, and short-lived movement in some a part of the body.
It normally affects the hands or face; for instance, it occurs when an individual moves his hand unconsciously, as if she or he were going to hit something. As that is something that can’t be controlled, this tends to affect the standard of lifetime of those who are suffering from it.
In itself, it is a condition related to diseases reminiscent of rheumatic fever or Huntington’s disease, although they should not its only causes. In this text, we’ll explain the whole lot it is advisable to learn about chorea and why it occurs.
What’s chorea?
Chorea is the medical term used to seek advice from rapid, involuntary, and jerky movements that typically occur within the distal portion of the limbs or within the face. Nonetheless, the trunk can be affected.
As explained in a publication within the National Institute of Neurological Disorders and Stroke the movements on this condition are unpredictable. They modify from one area of the body to a different, without following any sequence.
It normally appears as a consequence of lesions in certain brain areas, reminiscent of the caudate nucleus or the putamen. It isn’t a disease, but a clinical manifestation or symptom of other health disorders. Due to this fact, it’s not considered life-threatening in itself.
Nonetheless, because it normally occurs within the context of other pathologies, it could constitute a risk. Thus, depending on its cause, chorea could be temporary or not. Sometimes, it’s maintained and worsens progressively.
For instance, that is what happens in Huntington’s disease. It may additionally be accompanied by two other characteristic movements.
- Firstly, it could also be related to ballism’. This term refers to more intense movements, reminiscent of throwing an arm sharply and concisely.
- It could actually even be related to athetosis. On this case, what appears are slow movements, also uncontrollable. These resemble sustained wringing of the hands or limbs.
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The symptoms of chorea
Chorea normally produces involuntary movements of the limbs. Spasms of the limbs are also common. As there is no such thing as a pattern and it’s unpredictable, these occur at different places within the body.
In keeping with a publication of the Navarra University Clinic, at the start of the symptoms, people only experience nervous tics or excessive agitation. Nonetheless, as the image progresses, the movements grow to be more intense and marked.
Due to this fact, jerks of the top, extremities, or neck appear. These movements can interfere with the person’s every day life. It’s because they have an inclination to cause difficulties in speaking, interacting, walking, or eating.
Furthermore, the mood also deteriorates. Chorea often produces abrupt mood changes. It’s common for an individual with this condition to be apathetic, irritable, depressed, or aggressive. Cognitive functions are progressively impaired. Hence, memory or considering could also be affected.
Related diseases
Chorea may occur within the context of various pathologies. They are often classified based on whether or not they are acquired or hereditary. Throughout the hereditary ones, the principal cause is Huntington’s disease.
This represents a genetic disorder that is inherited in an autosomal dominant manner. That’s, just one copy of the defective gene is required for the disease to seem. On this disease, chorea is usually accompanied by personality disorders and speech problems.
Symptoms worsen progressively and, on average, patients have a life expectancy of 10 to 30 years when the manifestations appear. Unfortunately, there is no such thing as a cure for Huntington’s disease.
Chorea also can occur as a complication of rheumatic fever. This, in turn, is a complication of a bacterial infection (group A streptococcus). It’s common in children who’ve had streptococcal pharyngitis.
Other infections could also be associated, reminiscent of syphilis, Lyme disease or toxoplasmosis. Autoimmune diseases, reminiscent of systemic lupus erythematosus, also can cause it. The identical applies to multiple sclerosis or sarcoidosis.
Finally, endocrine disorders ought to be highlighted. Essentially the most common ones related to chorea are hypoglycemia, hyperglycemia, thyroid problems, and hypocalcemia.
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Causes and risk aspects for chorea
Chorea is usually a symptom of one other disorder. As a Cleveland Clinic article explains, an estimated 30,000 people in the US alone suffer from Huntington’s disease. Furthermore, there are roughly 4000 cases of Sydenham’s chorea per yr.
The incidence of Sydenham’s chorea itself is unknown. Nonetheless, cerebral vascular lesions are certainly one of its most significant causes. This explains why roughly 56 patients out of each 1,500 who’ve suffered a stroke eventually develop it.
To tell apart the reason behind this disorder, it’s useful to have a look at whether it presents acutely or progressively. Acute onset cases are often brought on by a toxic substance or a drug. For instance, levodopa to treat Parkinson’s disease or neuroleptics.
Meanwhile, as mentioned above, essentially the most typical progressive forms are brought on by Huntington’s disease and rheumatic fever.
Risk aspects
There are particular aspects that increase the danger of chorea. This can be a condition that may occur at any age. Nonetheless, it’s more typical in elderly patients and youngsters.
Within the elderly, it will probably occur with none apparent cause. Children, then again, usually tend to have rheumatic fever, so that they are those who are inclined to suffer from Sydenham’s chorea.
As one gets older, there may be also an increased risk of cardiovascular events. Strokes are related to chorea. The identical is true for tumors positioned near the basal ganglia of the brain.
Considered one of the most important risk aspects is family history. Particularly, having a member of the family with Huntington’s disease. Pregnancy is one other risk situation, even though it’s much less common and is normally self-limiting.
Being under certain medical treatments can increase the likelihood of getting this disorder. We noted earlier that it’s related to levodopa and neuroleptics. Other drugs may include anticonvulsants, antihistamines, or certain antidepressants.
How is it diagnosed?
Diagnosis of chorea could be complex, especially finding the underlying reason behind the condition. Suspicion is normally made on clinical grounds, when uncontrollable and unexplained nervous tics are observed.
It’s essential for the physician to know the patient’s medical history, past history, whether the patient has had any infection, whether there are other symptoms, etc. As well as, certain complementary tests are often performed to guide the diagnosis.
- To begin with, a whole blood test is really useful. Through this test, it’s possible to detect infections and hormonal or metabolic alterations. It’s also used to search for antibodies within the case of suspected autoimmune diseases.
- Imaging tests can be helpful. MRI and CT scans are used when a brain injury is suspected. For instance, a stroke.
- Finally, genetic testing could be performed to find out if it has its origin in Huntington’s disease.
Treatments available for chorea
Chorea is treated depending on what’s causing it. In keeping with an article by Mapfre Channels Health, Huntington’s disease has no treatment. There are only measures that can assist alleviate a few of the symptoms, but there is no such thing as a cure.
For instance, dopamine antagonists are used to try to cut back the movements. If psychiatric disturbances occur, neuroleptics, antidepressants, or anxiolytics could also be really useful.
Generally, most cases of chorea are treated with these drugs. Benzodiazepines are often essentially the most commonly used anxiolytics. Tetrabenazine and reserpine, which help reduce catecholamines, are also used.
If the cause is a metabolic disorder, it’s essential to correct it. Sydenham’s chorea is normally self-limiting. The movements are also treated with dopamine antagonists. For the condition itself, antibiotics reminiscent of penicillin are prescribed, which may eliminate the infection.
What to recollect about Chorea disease
Chorea itself is just not a disease, but can occur within the context of many disorders. Many individuals are inclined to use this term as a synonym for Huntington’s disease. Nonetheless, as now we have seen, it generally is a symptom of infections, metabolic disorders, autoimmune diseases, etc.
This symptom can seriously interfere with the sufferer’s life. Due to this fact, it’s essential to try to search out the cause quickly and establish the very best treatment in each case.
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