Chorea

Chorea means rapid, irregular and aimless movements that spread alternately from one part of the body to another. The word choreia comes from the Greek word choreia which means "dance". Mild choreatic movements do not even have to be observed clinically while moderate and severe chorea are often symptomatic although the patient himself is sometimes not even aware of it. In some cases, choreatic movements can turn into voluntary movements, leading the observer to think that the patient is trying to hide the chorea (parakinesia). Choreatic movements are associated with the impossibility of maintaining executive movement (motoric impersistence). Thus, patients may have difficulty keeping their tongue protruding (chameleon tongue) or maintaining a constant hand grip ("milk maid hand").

There are numerous causes of chorea and can be hereditary or acquired. The group of benign chorea includes benign familial chorea (often begins in the first decade of life and it is non-progressive without psychological and cognitive disturbances) and senile chorea (appearance of choreatic movements of the mouth, chewing and tongue movements). Chorea can occur as part of a number of hereditary neurodegenerative and neurometabolic diseases (Huntington's disease, Farh's disease, Wilson's disease, Lesh-Nyhan syndrome, spinocerebellar ataxias and others). Acquired causes of chorea include structural lesions of the brain (tumor, vascular changes, inflammatory diseases such as sarcoidosis, infectious diseases, immunological diseases such as antiphospholipid syndrome, Sydeman's chorea, postinfectious, paraneoplastic) metabolic disorders (hyperthyroidism, hypoparathyroidism, anoxia in cerebral paralysis, electrolyte imbalance, hyperglycemia and hypoglycemia), toxins (carbon monoxide, mercury, thallium, toluene) and drugs (anticonvulsants, antiparkinsonian drugs, cocaine, amphetamines, tricyclic antidepressants, neuroleptics).