Chorea Treatment in Mumbai, India

Chorea is a movement disorder characterized by sudden, irregular, and unpredictable movements that flow from one part of the body to another. These movements are often described as dance-like and can be involuntary, making it difficult for individuals to control their actions. Chorea can affect various body parts, including the face, arms, legs, and torso.

Associated Anatomy

Basal ganglia

Chorea Symptoms

Chorea is characterized by a range of symptoms that primarily involve involuntary movements. Here’s an overview of the common symptoms associated with chorea:

Involuntary Muscle Movements

Body parts commonly involved in fidgety or dance-like movements include the feet, hands, and face. Walking, eating, and talking all suffer as a result.

Milkmaid’s Grip

Because it appears like you’re milking a cow, it is a common way to shake someone’s hand.

Speech Issues

Slurred speech occurs when the muscles that make speech lose coordination.

Headaches and Seizures

Chorea may cause seizures and headaches in children.

Chorea Causes

Chorea is a neurological disorder with various underlying causes. Understanding these causes is essential for effective diagnosis and treatment. Key causes of chorea include:

Excessive Dopamine

Basal ganglia control movement. Too much dopamine in the basal ganglia causes chorea.

A Family History of Huntington’s Disease

You are 50% likely to have Huntington’s if you have a parent with it. It affects people aged 40 to 50.

Rheumatic Fever in Children

Untreated strep throat in children and adolescents causes Sydenham chorea.

Other Medical Conditions

Chorea is a symptom of autoimmune illnesses, hormone imbalances, and metabolic imbalances.

Chorea Stages

Chorea progresses through various stages, each marked by different levels of symptom severity and impact on daily functioning. Here’s an overview of the typical stages:

Early-Stage

Early-stage chorea patients may work, drive, manage money, and live independently. Some symptoms at this stage are uncontrollable movements, a slight lack of coordination, and trouble solving complicated issues.

Middle Stage

In middle-stage chorea, patients lose their ability to work, drive, manage finances, or carry out household chores. However, they can still eat, dress, and take care of personal hygiene with some help. Patients may have trouble with voluntary motor movements. Issues like difficulty swallowing, maintaining balance, weight loss, and even falling may occur. Individuals may find it difficult to sequence, arrange, or prioritize information, and problem-solving becomes difficult.

Late-Stage

Late-stage chorea patients need help with all the daily tasks. Despite being nonverbal and bedridden in the latter stages, patients appear to maintain some comprehension. Chorea may become severe and followed by rigidity, dystonia, and bradykinesia. Late-stage psychiatric disorders are often harder to detect and treat because patients face communication issues.

Chorea Tests

Your doctor may order tests for infections, lupus, thyroid, and other endocrine and metabolic issues. He can also advise MRI or CT scans to look for abnormalities in the brain. Tests to check whether the patient inherited the Huntington’s gene from the parents are also done.

Chorea Treatment

Treatment for chorea primarily aims to manage symptoms and improve quality of life. Key approaches include:

Medications

Some drugs stop your body from using dopamine receptors, and several of them tend to reduce chorea.

Surgeries

Deep brain stimulation (DBS) also helps with Chorea Treatment as an alternative to surgery. Implanted brain electrodes regulate electrical impulses.

If the medicine doesn’t work, your doctor may suggest DBS reduce its symptoms.

Home Care

The chorea increases the falling risk. Install non-slip surfaces on stairs and in restrooms to avoid injuries.

Chorea Preventions

The chances of blood cancer may increase due to the below:

Primary Prevention

• It is caused due to the mutation of the HTT gene. Since genes can’t be changed, there is not any concrete prevention.
• In the case of children, a check-up for sore throat could prevent rheumatic fever. If prescribed for strep throat, antibiotics should be taken as advised by the Chorea doctor.

Secondary Prevention

• Avoid rheumatic fever

Strep causes sore throats in children. Keep taking antibiotics as instructed by your child’s doctor if they have strep throat.

Chorea Risk Factors

Chorea risk factors vary depending on the underlying cause of the condition. Key risk factors include:

Rheumatic Fever

Sydenham chorea develops one to eight months after rheumatic fever. Untreated group A streptococcal infection develops Rheumatic fever.

Medications

Numerous drugs, including levodopa and neuroleptics linked to chorea. Antipsychotic drugs may potentially produce chorea due to tardive dyskinesia.

Toxins

Poisoning by CO, mercury, or alcohol may produce chorea.

Older Age

Chorea may occur in elderly persons for unknown reasons. The muscles in and around the mouth are particularly vulnerable to senile chorea, a degenerative disease of old age.

Huntington’s Disease

It causes personality changes, speech, coordination, memory issues, and chorea and The disease’s symptoms worsen with time.

Chorea Complications

Chorea may have serious complications. Huntington’s illness is progressive and incurable. Lupus has no cure, but physicians can help patients manage it with drugs. Children with Sydenham chorea resulting from rheumatic fever typically recover without problems.

Epidemiology

The worldwide incidence specific to chorea is unclear. However, around 5-10, people per 100,000 in the US are diagnosed with a neurological autosomal dominant condition.

Prognosis

Expected Prognosis

Chorea causes progressive impairment. No form of therapy that currently exists is known to delay, halt, or reverse this condition. Infections (most typically pneumonia) and accidents from falls are the most common causes of mortality in chorea.

Natural Progression

Chorea is a movement disorder that occurs because of various medical conditions. While it is not life-threatening, it may indicate a neurological disorder like Huntington’s disease.

Chorea can be a short-term or long-term ailment, depending on the cause.

Medications can control irregular muscular movements.

Frequently Asked Questions

1. Is Chorea a Diagnosis?

No, chorea is not a diagnosis itself. It is a movement disorder characterised by involuntary, jerky movements, and it can be a symptom of an underlying condition or disease such as  genetic conditions, autoimmune or infectious conditions, metabolic disorders or specific medication. 

2. What is Acute Chorea Disease?

Acute chorea refers to the sudden onset of chorea symptoms, which can be caused by various conditions Sydenham's chorea (a complication of rheumatic fever), or certain metabolic disorders.

3. What is The Blood Test for Chorea?

There is no specific blood test for chorea. However, blood tests may be performed to assess underlying causes or conditions associated with chorea, such as genetic tests for Huntington's disease or tests for infections and autoimmune disorders.

4. Is Chorea Curable?

The underlying cause of chorea determines its durability. Sometimes, treating the underlying disease can help manage or even resolve chorea symptoms. However, in certain cases, chorea may be a chronic or progressive condition with limited curative options. While some conditions may improve upon themselves, others like Huntington’s disease progress over a period of time and have no cure. 

5. What Bacteria Causes Chorea? 

The bacteria known as Group A Streptococcus (GAS) is commonly associated with chorea, particularly in cases of Sydenham's chorea, which is a complication of rheumatic fever.

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