Chorea: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
(/* Causes In alphabetical order. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016 Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Mass...)
Line 46: Line 46:
| '''Chemical / poisoning'''
| '''Chemical / poisoning'''
|bgcolor="Beige"|
|bgcolor="Beige"|
[[Carbon  monoxide toxicity ]]
[[Carbon  monoxide toxicity ]], [[Toulene poisioning ]]
 
[[Toulene poisioning ]]


|-
|-
Line 58: Line 56:
| '''Drug Side Effect'''
| '''Drug Side Effect'''
|bgcolor="Beige"|  
|bgcolor="Beige"|  
 
[[Amphetamines  ]], [[Ethotoin ]], [[Lamotrigine ]], [[Levodopa, Dopamine agonists  ]], [[Levomepromazine ]], [[Lithium  ]], [[Methadone ]], [[Oral contraceptive pills ]], [[Phenothiazines ]], [[Phenytoin ]], [[Tolcapone ]], [[Tricyclic antidepressants ]].
[[Amphetamines  ]]
 
[[Ethotoin ]]
 
[[Lamotrigine ]]
 
[[Levodopa, Dopamine agonists  ]]
 
[[Levomepromazine ]]
 
[[Lithium  ]]
 
[[Methadone ]]
 
[[Oral contraceptive pills ]]
 
[[Phenothiazines ]]
 
[[Phenytoin ]]
 
[[Tolcapone ]]
 
[[Tricyclic antidepressants ]]


|-
|-
Line 91: Line 66:
| '''Endocrine'''
| '''Endocrine'''
|bgcolor="Beige"|  
|bgcolor="Beige"|  
[[Hypoglycaemia  ]]
[[Hypoglycaemia  ]], [[Hypoparathyroidism]], [[Thyrotoxicosis ]].
 
[[Hypoparathyroidism.]]
 
[[Thyrotoxicosis ]]


|-
|-
Line 109: Line 80:
| '''Genetic'''
| '''Genetic'''
|bgcolor="Beige"|  
|bgcolor="Beige"|  
[[De  Barsy syndrome ]]
[[De  Barsy syndrome ]], [[McLeod phenotype  ]]
 
[[McLeod phenotype  ]]


|-
|-
Line 117: Line 86:
| '''Hematologic'''
| '''Hematologic'''
|bgcolor="Beige"|  
|bgcolor="Beige"|  
[[Ceruloplasmin  deficiency ]]
[[Ceruloplasmin  deficiency ]], [[Polycythemia ]], [[Porphyria ]], [[Henosch  - scholein purpura]].
 
[[Polycythemia ]]
 
[[Porphyria ]]
[[Henosch  - scholein purpura]]


|-
|-
Line 133: Line 97:
|bgcolor="Beige"|  
|bgcolor="Beige"|  


[[Rheumatic  Fever ]]
[[Rheumatic  Fever ]], [[HIV ]]
 
[[HIV ]]


|-
|-
Line 146: Line 108:
|bgcolor="Beige"|  
|bgcolor="Beige"|  


[[Huntington’s  disease ]]
[[Huntington’s  disease ]], [[Movement disorders ]], [[Ganglion ]], [[Wilson’s disease ]], [[Neuroacanthocytosis ]], [[Paroxysmal choreoathetosis  ]], [[Cerebral birth injury ]], [[Kernicterus ]], [[cerebral trauma ]], [[Lacunar infarction ]], [[Creutzfeldt- Jacob disease  ]], [[Cebral Palsy ]][[Spinocerebellar ataxia 17 ]][[Olivopontocerebellar atrophy  1 ]][[Idiopathic basal ganglia  calcification ]], [[Hallervorden – Spatz disease  ]], [[Troyer syndrome ]], [[Dentatorubropallidoluysian  degeneration ]], [[Westphal disease ]], [[Neuhauser- Eichner –Opitz  syndrome ]], [[Alternating hemiplegia of  childhood ]], [[Spinocerebeller ataxia  recessive 1 ]], [[Microcephaly-pontocerebellarhypoplasia-dyskinesia  ]], [[Ataxia – telangiectasia ]], [[Cross- McKusick-Breen  syndrome ]], [[Paroxysmal kinesigenic  choreoathetosis ]], [[Neuroferritinopathy ]], [[Wolfram’s disease ]], [[Mount Reback syndrome ]], [[Paroxysmal nonkinesigenic  choreathetosis ]], [[Gilles de la tourette  syndrome ]], [[Fahr’s syndrome ]], [[Familial benign chorea]].
 
[[Movement disorders ]]
 
[[Ganglion ]]
 
[[Wilson’s disease ]]
 
[[Neuroacanthocytosis ]]
 
[[Paroxysmal choreoathetosis  ]]
 
[[Cerebral birth injury ]]
 
[[Kernicterus ]]
 
[[cerebral trauma ]]
 
[[Lacunar infarction ]]
 
[[Creutzfeldt- Jacob disease  ]]
 
[[Cebral Palsy ]]
 
[[Spinocerebellar ataxia 17 ]]
 
[[Olivopontocerebellar atrophy  1 ]]
 
[[Idiopathic basal ganglia  calcification ]]
 
[[Hallervorden – Spatz disease  ]]
 
[[Troyer syndrome ]]
 
[[Dentatorubropallidoluysian  degeneration ]]
 
[[Westphal disease ]]
 
[[Neuhauser- Eichner –Opitz  syndrome ]]
 
[[Alternating hemiplegia of  childhood ]]
 
[[Spinocerebeller ataxia  recessive 1 ]]
 
[[Microcephaly-pontocerebellarhypoplasia-dyskinesia  ]]
 
[[Ataxia – telangiectasia ]]
 
[[Cross- McKusick-Breen  syndrome ]]
 
[[Paroxysmal kinesigenic  choreoathetosis ]]
 
[[Neuroferritinopathy ]]
 
[[Wolfram’s disease ]]
 
[[Mount Reback syndrome ]]
 
[[Paroxysmal nonkinesigenic  choreathetosis ]]
 
[[Gilles de la tourette  syndrome ]]
 
[[Fahr’s syndrome ]]
 
[[Familial benign chorea]]


|-
|-
Line 217: Line 115:
|bgcolor="Beige"|  
|bgcolor="Beige"|  


[[Pyruvate  decarboxylase deficiency ]]
[[Pyruvate  decarboxylase deficiency ]], [[3- Methylglutaconic aciduria  type 3 ]], [[Benedikt’s syndrome ]], [[Infantile epileptic –  dyskinetic encephalopathy ]], [[Ceroid lipofuscinosis ]], [[Glutaric aciduria type 1 ]], [[Lesch-Nyhan syndrome ]].
 
[[3- Methylglutaconic aciduria  type 3 ]]
 
[[Benedikt’s syndrome ]]
 
[[Infantile epileptic –  dyskinetic encephalopathy ]]
 
[[Ceroid lipofuscinosis ]]
 
[[Glutaric aciduria type 1 ]]
 
[[Lesch-Nyhan syndrome ]]


|-
|-
Line 267: Line 153:
| '''Rheum / Immune / Allergy'''
| '''Rheum / Immune / Allergy'''
|bgcolor="Beige"|  
|bgcolor="Beige"|  
[[SLE ]]
[[SLE ]], [[Henosch - scholein purpura]].
 
[[Henosch - scholein purpura]]


|-
|-
Line 288: Line 172:
|bgcolor="Beige"|  
|bgcolor="Beige"|  


[[Arterio-venous  malformations ]]
[[Arterio-venous  malformations ]], [[Senile chorea ]], [[Haw river syndrome  ]].
 
[[Senile chorea ]]
 
[[Haw river syndrome  ]]


|-
|-

Revision as of 04:55, 24 August 2012

Chorea
ICD-10 G25.5
ICD-9 333.5
DiseasesDB 16662
MeSH D002819

Template:Search infobox Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Chorea sancti viti (Latin for "St. Vitus' dance") is an abnormal involuntary movement disorder, one of a group of neurological disorders called dyskinesias. The term chorea is derived from a Greek word χορεία (a kind of dance), as the quick movements of the feet or hands are vaguely comparable to dancing or piano playing.

Presentation

Chorea is characterized by brief, irregular contractions that are not repetitive or rhythmic, but appear to flow from one muscle to the next.

These 'dance-like' movements of chorea (from the same root word as "choreography") often occur with athetosis, which adds twisting and writhing movements.

Causes

Chorea can occur in a variety of conditions and disorders.


Causes by Organ System

  • To obtain the coding for the table seen below, click here. You need to copy the table content from the edit box, and paste it into the edit box.
  • You can then list the causes by organ system. List the causes, separated by a comma under the appropriate category where it says "No underlying causes". Erase "No underlying causes" if you are listing causes in that category.
  • For an example of the causes by organ system table in a causes microchapter, click here.
Cardiovascular No underlying causes
Chemical / poisoning

Carbon monoxide toxicity , Toulene poisioning

Dermatologic No underlying causes
Drug Side Effect

Amphetamines , Ethotoin , Lamotrigine , Levodopa, Dopamine agonists , Levomepromazine , Lithium , Methadone , Oral contraceptive pills , Phenothiazines , Phenytoin , Tolcapone , Tricyclic antidepressants .

Ear Nose Throat No underlying causes
Endocrine

Hypoglycaemia , Hypoparathyroidism, Thyrotoxicosis .

Environmental No underlying causes
Gastroenterologic No underlying causes
Genetic

De Barsy syndrome , McLeod phenotype

Hematologic

Ceruloplasmin deficiency , Polycythemia , Porphyria , Henosch - scholein purpura.

Iatrogenic No underlying causes
Infectious Disease

Rheumatic Fever , HIV

Musculoskeletal / Ortho No underlying causes
Neurologic

Huntington’s disease , Movement disorders , Ganglion , Wilson’s disease , Neuroacanthocytosis , Paroxysmal choreoathetosis , Cerebral birth injury , Kernicterus , cerebral trauma , Lacunar infarction , Creutzfeldt- Jacob disease , Cebral Palsy Spinocerebellar ataxia 17 Olivopontocerebellar atrophy 1 Idiopathic basal ganglia calcification , Hallervorden – Spatz disease , Troyer syndrome , Dentatorubropallidoluysian degeneration , Westphal disease , Neuhauser- Eichner –Opitz syndrome , Alternating hemiplegia of childhood , Spinocerebeller ataxia recessive 1 , Microcephaly-pontocerebellarhypoplasia-dyskinesia , Ataxia – telangiectasia , Cross- McKusick-Breen syndrome , Paroxysmal kinesigenic choreoathetosis , Neuroferritinopathy , Wolfram’s disease , Mount Reback syndrome , Paroxysmal nonkinesigenic choreathetosis , Gilles de la tourette syndrome , Fahr’s syndrome , Familial benign chorea.

Nutritional / Metabolic

Pyruvate decarboxylase deficiency , 3- Methylglutaconic aciduria type 3 , Benedikt’s syndrome , Infantile epileptic – dyskinetic encephalopathy , Ceroid lipofuscinosis , Glutaric aciduria type 1 , Lesch-Nyhan syndrome .

Obstetric/Gynecologic

Pregnancy

Oncologic No underlying causes
Opthalmologic No underlying causes
Overdose / Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary No underlying causes
Renal / Electrolyte

Henosch - scholein purpura

Rheum / Immune / Allergy

SLE , Henosch - scholein purpura.

Sexual No underlying causes
Trauma No underlying causes
Urologic No underlying causes
Miscellaneous

Arterio-venous malformations , Senile chorea , Haw river syndrome .

Ballism

When chorea is serious, slight movements will become thrashing motions; this form of severe chorea is referred to as ballism. Walking may become peculiar, and include odd postures and leg movements. Unlike ataxia and dystonia, which affect the quality of voluntary movements or parkinsonism, which is a hindrance of voluntary movements, the movements of chorea and ballism occur on their own, without conscious effort.

Causes In alphabetical order. [1] [2]

Amphetamines

Carbon monoxide toxicity

Ceruloplasmin deficiency

De Barsy syndrome

Ethotoin

Hypoglycaemia

Hypoparathyroidism.

Lamotrigine

Levodopa, Dopamine agonists

Levomepromazine

Lithium

McLeod phenotype

Methadone

Oral contraceptive pills

Phenothiazines

Phenytoin

Polycythemia

Porphyria

Thyrotoxicosis

Tolcapone

Toulene poisioning

Tricyclic antidepressants

Rheumatic Fever

HIV

Huntington’s disease

Movement disorders

Ganglion

Wilson’s disease

Neuroacanthocytosis

Paroxysmal choreoathetosis

Cerebral birth injury

Kernicterus

cerebral trauma

Lacunar infarction

Creutzfeldt- Jacob disease

Cebral Palsy

Spinocerebellar ataxia 17

Olivopontocerebellar atrophy 1

Idiopathic basal ganglia calcification

Hallervorden – Spatz disease

Troyer syndrome

Dentatorubropallidoluysian degeneration

Westphal disease

Neuhauser- Eichner –Opitz syndrome

Alternating hemiplegia of childhood

Spinocerebeller ataxia recessive 1

Microcephaly-pontocerebellarhypoplasia-dyskinesia

Ataxia – telangiectasia

Cross- McKusick-Breen syndrome

Paroxysmal kinesigenic choreoathetosis

Neuroferritinopathy

Wolfram’s disease

Mount Reback syndrome

Paroxysmal nonkinesigenic choreathetosis

Gilles de la tourette syndrome

Fahr’s syndrome

Familial benign chorea

Pyruvate decarboxylase deficiency

3- Methylglutaconic aciduria type 3

Benedikt’s syndrome

Infantile epileptic – dyskinetic encephalopathy

Ceroid lipofuscinosis

Glutaric aciduria type 1

Lesch-Nyhan syndrome

Pregnancy

Respiratory failure

SLE

Henosch - scholein purpura

Arterio-venous malformations

Senile chorea

Haw river syndrome

Diagnosis

History and Symptoms

  • Complete history required
  • Psychiatric symptoms (Huntington's)

Appearance of the Patient

Eyes

Laboratory Findings

MRI and CT

Echocardiography or Ultrasound

  • In order to diagnose carditis, an ECG may be indicated

Other Imaging Findings

  • In order to reveal cerebral and cerebellar atrophies in patients with DRPLA, various imaging studies are indicated

Other Diagnostic Studies

Treatment

Cause Treatment
Huntington's disease A common treatment is dopaminergic antagonists, although treatment is largely supportive.
Sydenham's chorea Usually involves antibiotic drugs to treat the infection, followed by drug therapy to prevent recurrence.
Drug-induced chorea. Adjusting medication dosages.
Metabolic and endocrine-related choreas Treated according to the cause(s) of symptoms.

Acute Pharmacotherapies

References

  1. ↑ Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
  2. ↑ Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X

See also

Template:Diseases of the nervous system


Template:WikiDoc Sources

Retrieved from "https://www.wikidoc.org/index.php?title=Chorea&oldid=695794"