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  • Updated 06.06.2023
  • Released 08.05.1994
  • Expires For CME 06.06.2026




Chorea, derived from the Latin choreus meaning "dance," describes a syndrome characterized by irregular, hyperkinetic, involuntary movements resulting from a continuous flow of random muscle contractions. Athetosis refers to the writhing, slow, and irregular movements involving the hand and fingers. Choreoathetosis is the term to describe chorea with a writhing quality. When chorea is mild, it is difficult to differentiate from restlessness. Proximal flinging movements are referred to as ballism. Although the mechanism is not completely understood, chorea is thought to result from the imbalance in the direct and indirect pathways in the basal ganglia circuitry (14). Primary chorea is either idiopathic or hereditary. Secondary chorea is related to autoimmune, vascular, infectious, pharmacologic, and metabolic disorders. The author aims to provide an up-to-date discussion of the clinical presentations, etiology, pathogenesis, differential diagnosis, and management of this order.

Key points

• The etiology of chorea includes genetic, idiopathic, autoimmune, pharmacological, metabolic, and structural lesions.

• Vascular disease of the brain is the most common cause of nongenetic chorea in adults.

• Treatment for chorea is based on reversing the underlying cause of chorea, if feasible.

• Antiepileptics and antipsychotics are the mainstay therapy to achieve symptomatic control of chorea, regardless of the underlying etiology. Dopamine depletion achieved by inhibition of vesicular monoamine transporter-2 (VMAT2) has been used to treat patients with Huntington disease, tardive dyskinesia, and other movement disorders.

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