Chorea

Chorea is a symptom of several diseases affecting the basal ganglia of the brain. Typical are ( predominantly in the waking state) involuntary, sudden, rapid, irregular movements of the extremities, face, neck and trunk, occurring both at rest and during voluntary movements.

Definition of chorea

Choreatic movement disorders belong to the large group of extrapyramidal hyperkinesis, which include include tremor, dystonia that, the ballism or the tics in Tourette's syndrome. All extrapyramidal hyperkinesis due to a malfunction in each case of certain portions of the basal ganglia.

Chorea (Greek for dance) is not a disease but a purely descriptive term for a symptom, the number of very different underlying reasons. But the end result is always a malfunction of the striatum, which then leads to very characteristic movement disorders.

Occurrence

Chorea occurs in:

  • Chorea major ( Huntington ): inherited, degenerative chorea, the so-called hereditary chorea
  • Chorea minor ( Sydenham ): post - infectious autoimmune- induced chorea; especially children concerned, immune-mediated sequelae after infection with streptococci, often combined with rheumatic fever, see also PANDAS
  • Neuroacanthocytosis syndromes ( McLeod syndrome, chorea - acanthocytosis )
  • Benign hereditary chorea
  • Disorders of metabolism (especially hyperthyroidism)
  • Collagenosis (e.g., chorea in systemic lupus erythematosus (SLE) )
  • Wilson's disease
  • Chorea senilis / hemichorea: the right or left half of the body as a result concerning condition after stroke or both sides by hypoperfusion of the brain
  • Chorea gravidarum: especially in pregnant women for the first time, possibly a subtype of chorea
  • Through medication chorea triggered (eg by L- dopa overdose in the treatment of Parkinson's disease, the TB drugs isoniazid and some birth control pills, some antipsychotics, anticonvulsants )
  • Rare: in multiple sclerosis

Diagnostics

  • Case history
  • Neurological status
  • Neuropsychological Status
  • Psychiatric examination
  • Determination of ceruloplasmin in serum - mirror
  • Thyroid
  • Kollagenosendiagnostik
  • Acanthocytes in a blood smear
  • Investigation of the genetic defect

And possibly even

  • Cerebral imaging ( cCT, cMRI or positron emission tomography (PET ) )
  • Neurophysiological studies ( somatosensory evoked potentials (SEP ), blink reflex, electronystagmography )
  • Examination of the cerebrospinal fluid

Determination of heavy metals in the serum and / or urine

Round dance Huntington's disease Sydenham's chorea Thomas Sydenham Serum (blood) Blood film Medical guideline
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