Everything to Know About Chorea

Medically Reviewed By Heidi Moawad, M.D.

Chorea is a type of involuntary movement. It is a symptom of another condition, such as Huntington’s disease. When people have chorea, they display brief, abrupt, and irregular body movements. They start in one body part and flow to others. Identifying and treating the underlying cause may resolve chorea. For chronic chorea, the goals of treatment are to minimize symptoms and cope with the condition through a variety of therapies.

This article describes chorea and explains its causes. Keep reading to learn how doctors approach diagnosis and treatment, as well as get answers to frequently asked questions about chorea.

What does chorea mean?

middle aged or senior female sitting on chair with legs dangling over the side
Mal de Ojo Studio/Stocksy United

Chorea involves excessive, spontaneous movements that you cannot control. The movements have irregular timing and are abrupt. They flow from one muscle or body part to the next unpredictably. This can make the motions appear dance-like.

Chorea is a main symptom of Huntington’s disease, explains the National Institute of Neurological Disorders and Stroke (NINDS). This progressive brain condition is relatively rare. In the United States, there are about 5–10 cases per 100,000 Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source people.

Chorea can also occur as an effect of certain drugs or as a complication of rheumatic fever. The latter is Sydenham’s chorea. It affects about 20% of children and teens who get rheumatic fever after a strep infection, according to NINDS.

What does chorea look like?

The involuntary movements of chorea range from mild to severe. When they are mild, a person may just seem clumsy or restless. Severe chorea can be intense. 

Chorea can affect any body part, but it usually involves the face, hands, and feet. In the face, it can manifest as random nose wrinkling or movements of the eyes, mouth, or tongue.

Chorea can make it hard for people to talk, swallow, walk, or maintain proper posture. People may have trouble holding things and may drop objects often. These movements and problems may settle during sleep for some people.

There are two types Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source of movements that usually accompany chorea:

  • Athetosis: This is a slow form of chorea. The movements are continuous, writhing, and twisting in nature. They most often affect the hands and feet.
  • Ballism or ballismus: This is forceful flinging of an arm or leg. It most often affects one side of the body, but can involve both sides in rare cases.

Learn more about involuntary movements here.

What can cause chorea?

Chorea is the result of overactivity in the basal ganglia — a region deep in the brain. This area coordinates voluntary movements. It smooths them and keeps them consistent. Problems in this brain region will cause loss of fluidity and purpose in body motions.

There are several Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source  neurotransmitters involved in chorea. However, dopamine is the main one. Too much dopamine in the basal ganglia likely leads to the overactivity in the area. “Dyskinesia” is a term clinicians may use to describe involuntary movements due to this overactivity.

Medical causes of chorea

Possible causes of chorea include:

Drug causes of chorea

Drugs that affect dopamine levels or nerve cell sensitivity to dopamine can cause or worsen chorea. Drugs include:

  • amphetamines
  • anticonvulsants
  • antihistamines
  • antipsychotics
  • cocaine
  • levodopa, which is a drug that can replace dopamine to treat slowness of movement in people with Parkinson’s disease
  • oral contraceptives
  • tricyclic antidepressants

Sometimes doctors cannot identify a cause. This is idiopathic chorea.

What types of tests can help diagnose the cause?

Doctors can tell you have chorea by observing the movements. Diagnosis of the underlying cause will involve an exam and testing. Tests your doctor may order include:

  • blood chemistry tests
  • complete blood count 
  • imaging exams, such as CT, MRI, or PET scans

The movements characterized by chorea look similar to tics, tardive dyskinesia, and other involuntary movements. Your doctor will want to distinguish chorea from these other conditions.

How do doctors treat chorea?

In general, treating chorea depends on the underlying cause. Sometimes treating the root cause can cure the chorea, such as removing a brain tumor.

If a medication causes chorea, adjusting the dose of it may help.

Chorea of pregnancy will resolve at or after delivery. If it is severe, doctors can treat it before delivery with sedative drugs known as barbiturates.

For other causes, doctors must manage the chorea because they cannot cure it. This is the case with Huntington’s disease and hereditary chorea. Doctors use drugs that block dopamine or deplete it to help manage chorea symptoms. They include:

  • deutetrabenazine (Austedo)
  • tetrabenazine (Xenazine)
  • valbenazine (Ingrezza)

Deep brain stimulation may help sometimes. However, it is still experimental Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source  and will not help all people with chorea. Clinical trials may be an option if other treatments do not reduce symptoms. Talk with your doctor about the possibility of participating in chorea research.

What is the outlook for people with chorea?

The outlook for people with chorea depends on the underlying cause. Some causes are curable. However, Huntington’s disease is progressive and chorea will not go away.

Learn more about Huntington’s chorea here.

For people living with chorea, various forms of therapy can help cope with it. In addition to mental health therapy, people can benefit from occupational, physical, speech, and swallowing therapy.

Support groups and social services can also help. The Huntington’s Disease Society of America is one place to start.

Frequently asked questions

Here are some other questions that people often ask about chorea.

What is the most common cause of chorea? 

The most common cause of chorea is a drug side effect. In adults, Huntington’s disease is the most common degenerative cause of chorea.

Is chorea the same as Huntington’s disease?

Chorea is a symptom of Huntington’s disease, an inherited brain condition. In fact, another name for it is Huntington’s chorea. People with Huntington’s disease also have cognitive and psychiatric symptoms.

Learn more about Huntington’s chorea and other symptoms here.

Summary

The term “chorea” describes uncontrollable and abrupt movements. There are several possible causes. Because it is a symptom, getting at the root cause is key to understanding it. The underlying disorder will determine the way you treat it and your outlook for the future. 

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Medical Reviewer: Heidi Moawad, M.D.
Last Review Date: 2022 Jun 10
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