An irregular, unpredictable, random, jerky, movements that flow from one body part to another or a complete inability to sustain a steady body position. Athetosis is slower than chorea. It is acceptable to use the term “choreoathetosis”

Causes

Inherited degenerative diseases

  • Huntington’s disease
  • Benign familial chorea
  • Neuroacanthocytosis

Click here for more on Huntington’s disease

Toxins / Drugs

  • Birth control pill
  • Dilantin (phenytoin)
  • Levodopa

Vascular causes (strokes)

  • Polycythemia (a disorder associated with too many red blood cells)
  • Hypertensive basal ganglia (lacunar) strokes
  • Vasculitis (inflammation of blood vessels)

Metabolic disorders

  • Hyperthyroidism (overactive thyroid)
  • Chorea gravidarum (pregnancy-induced chorea)
  • Chronic liver failure
  • Hypoglycemia (low blood sugar)

Inherited metabolic diseases

  • Wilson’s disease (an inherited abnormality of copper storage)

Paroxysmal (episodic) choreoathetosis

  • Paroxymal kinesigenic dyskinesia (episodic chorea induced by movement)
  • Paroxysmal non-kinesigenic dyskinesia (episodic chorea not induced by movement)
  • Paroxysmal exertion dyskinesia (episodic chorea induced by exercise)

Infectious

  • Sydenham’s chorea (associated with Rheumatic fever)
  • Syphillis
  • HIV/AIDS

Auto-immune

  • NMDA receptor encephalitis

For more information, please see the diagnostic flow chart by Dr. Ruth Walker.

Treatment

Treatment needs to proceed with caution. Frequently treatment settles chorea but the functional status of the patient is worsened.

A variety of medications can be used to help settle chorea including; tetrabenazine, reserpine, Trilafon (perphenazine), Haldol (haloperidol) and other neuroleptic medications.

Additional resources