Chorea

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Background

Chorea is a movement disorder characterized by involuntary worm-like movements.

Differential Diagnosis

Autoimmune

  1. Sydenham's Chorea - due to Acute Rheumatic Fever
  2. Lupus
  3. Oral Contraceptives [1]
  4. Chorea Gravidarum - usually in 1st trimester pregnancy [2]

Vascular

  1. Stroke
  2. Postpump Chorea - in children after cardiac surgery
  3. Polycythemia Vera

Paraneoplastic

  1. Small-cell lung CA

Metabolic Disorders

  1. Nonketotic hyperglycemia [3]
  2. Hyperthyroidism (rare)
  3. Renal Failure
  4. Hypocalcemia

Drugs

  1. Illicit Drugs
    1. Cocaine
    2. Methamphetamines
  2. Dopamine Receptor Antagonists
    1. Metoclopramide (Reglan)
  3. Cimetidine
  4. Digoxin
  5. Isoniazid
  6. Verapamil
  7. Theophylline

Workup

Management

Treat the underlying disorder

Disposition

  • Consult Neurology if cause is unclear

See Also

Sources

  • Medscape (www.medscape.com/viewarticle/705907_6)
  1. ↑ Miranda M, et al. Oral contraceptive induced chorea: another condition associated with anti0basal ganaglia antibodies. J Neurol Neurosurg Psychiatry 2004; 75(2): 327-328
  2. ↑ Bordelon YM, et al. Movement disorders in pregnancy. Semin Neurol 2007; 27(5):467-475
  3. ↑ Chang MH, et al. Non0ketotic hyperglycaemic chorea: a SPECT study. J Neurol neurosurg Psychiatry 1996; 60(4): 428-430
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