What is chorea and what causes it?
Chorea is a movement disorder that causes random, brief, involuntary movements. It can occur in any part of the body and unexpectedly move to another body part. It is thought to be due to interference or damage to the part of the brain that controls movement (the basal ganglia). In this area of the brain, there may be overactivity of a brain-signalling chemical (neurotransmitter) called dopamine.
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There are a number of causes of chorea, and it can affect anyone of any age:
Sydenham’s chorea is the most common cause of chorea worldwide. It occurs as part of an illness called rheumatic fever, which is the result of the body’s immune system causing widespread inflammation in response to an infection. Children aged 5-15 years are the most likely to be affected.
Huntington’s disease is an inherited genetic disease that slowly and progressively damages the brain and nervous system. This leads to chorea as well as changes in behaviour and judgement.
Wilson’s disease is another inherited genetic disease, which leads to the build-up of copper in the body. In addition to chorea, it also causes liver problems and behaviour changes.
Pregnancy can occasionally cause chorea. In some cases, it will stop on its own before the birth of the baby, but otherwise the symptoms disappear shortly after delivery.
Medications may cause chorea due to their interactions with neurotransmitters in the brain. Some of the treatments for Parkinson’s disease, schizophrenia, and epilepsy have been associated with chorea.
What are the symptoms of chorea?
The movements of chorea often involve the face, head or limbs. It can appear to look like fidgeting or dancing (the word ‘chorea’ is from the Greek word for dance). They don’t have a regular pattern and are not repetitive. Chorea causes difficulties in holding onto objects and, if it affects the legs, can cause falls.
How is chorea diagnosed?
Here at The London Clinic, we have leading specialists who are experienced in the diagnosis of chorea. They will begin by asking questions about the symptoms, medical conditions and family history, before performing a full clinical assessment.
There are no specific tests for chorea, so the diagnosis is mostly based on symptoms as well as the clinical assessment. Blood tests and MRI scans of the brain may also be used to help diagnosis and identify the cause.
What are the common treatments for chorea?
If the chorea is caused by an underlying medical condition or medication, then treatment involves managing that effectively. If there is no obvious cause, treatment will be aimed at reducing and controlling symptoms:
Medications are used to block the effects or reduce the amount of the neurotransmitter dopamine. Anti-psychotic medicines are often effective at blocking dopamine activity, and dopamine-depleting drugs can successfully lower the amount of dopamine in the body.
Surgery can be used if the medications don’t work. A surgical procedure called deep brain stimulation may be offered. This involves inserting tiny wires called electrodes into the region of the brain responsible for the chorea. The electrodes are connected to a small electrical device that sits under the skin – this delivers a painless electrical stimulation to block the signals causing the chorea.
Why choose The London Clinic?
The London Clinic differs from other private hospitals. As a charity, we re-invest into our facilities because we believe in bringing the most expert care to every patient. We offer cutting-edge technology and a unique multidisciplinary team, with leading specialists and clinical support teams that are second to none.