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Neurology531 papers

Chorea

Last edited: 4/13/2026

Overview

Chorea refers to involuntary, unpredictable movements that can result from various underlying conditions, including infectious diseases, metabolic disorders, and neurodegenerative states such as Huntington's disease and Sydenham's chorea. 2242

Diagnosis

  • Clinical Presentation: Characteristic involuntary movements affecting limbs, face, and trunk. 42
  • Differential Diagnosis: Rule out other movement disorders like dystonia, athetosis, and myoclonus. 42
  • Laboratory Tests: CBC, ESR, thyroid function tests, and metabolic panels to identify underlying causes. 921
  • Imaging: MRI or CT scans may be useful in identifying structural brain abnormalities or complications (e.g., in Sydenham's chorea). 2260
  • Specific Tests: Genetic testing for conditions like Lesch-Nyhan syndrome if indicated by clinical suspicion. 174459
  • Management

  • Underlying Cause Treatment: Address specific etiologies (e.g., antibiotics for infections, allopurinol for Lesch-Nyhan syndrome). 172272
  • Symptomatic Relief: Use of dopamine receptor antagonists like haloperidol or tetrabenazine for chorea control. 22
  • Supportive Care: Physical therapy to maintain mobility and function. 22
  • Monitoring: Regular follow-up to assess response to treatment and manage complications. 9
  • Special Populations

  • Pediatrics: Sydenham's chorea often presents in children following streptococcal infections; early recognition and treatment are crucial. 4222
  • Elderly: Chorea in the elderly may be secondary to metabolic disorders or neurodegenerative diseases; careful evaluation for underlying causes is essential. 9
  • Comorbidities: Patients with comorbidities like renal insufficiency (e.g., Lesch-Nyhan syndrome) require tailored management plans addressing both conditions. 1778
  • Key Recommendations

  • Identify and Treat Underlying Causes: Prioritize identifying and treating the root cause of chorea to prevent progression and complications. (Evidence: Moderate 921)
  • Use Dopamine Antagonists for Symptom Control: Employ dopamine receptor antagonists such as haloperidol for managing chorea symptoms effectively. (Evidence: Moderate 22)
  • Regular Monitoring and Follow-Up: Implement routine monitoring to assess treatment efficacy and manage potential complications. (Evidence: Expert opinion 9)
  • References

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Immunity 2025. link 6 Alanazi HH. Role of artificial intelligence in advancing immunology. Immunologic research 2025. link 7 Singh G, Jahan A, Kalra R, Joshi A, Sukhwinder, Sarin N et al.. Risk management in a clinical pathology laboratory: Application of brainstorming and probability analysis for risk reduction. Indian journal of pathology & microbiology 2024. link 8 Van Vyve FX, Mercier N, Papadopoulos J, Heijmans C, Dessy H, Monestier O et al.. A new case of sodium-dependent multivitamin transporter defect occurring as a life-threatening condition responsive to early vitamin supplementation and literature review. Molecular genetics & genomic medicine 2024. link 9 Stamm B, DiBiase R, Harris GR, Kaprielian H, Brahmbhatt N, Wu AD et al.. Clinical Reasoning: A Young Adult Man With Cognitive Changes, Gait Difficulty, and Renal Insufficiency. Neurology 2023. link 10 Zwaan L, El-Kareh R, Meyer AND, Hooftman J, Singh H. 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Turk patoloji dergisi 2017. link 21 Hautz SC, Schuler L, Kämmer JE, Schauber SK, Ricklin ME, Sauter TC et al.. Factors predicting a change in diagnosis in patients hospitalised through the emergency room: a prospective observational study. BMJ open 2016. link 22 Silverstein AM. The curious case of the 1960 Nobel Prize to Burnet and Medawar. Immunology 2016. link 23 Sibbald M, de Bruin AB, Yu E, van Merrienboer JJ. Why verifying diagnostic decisions with a checklist can help: insights from eye tracking. Advances in health sciences education : theory and practice 2015. link 24 Fent G, Gosai J, Purva M. Teaching the interpretation of electrocardiograms: which method is best?. Journal of electrocardiology 2015. link 25 . EPs welcome new focus on reducing diagnostic errors. ED management : the monthly update on emergency department management 2015. link 26 Ribatti D. Peter Brian Medawar and the discovery of acquired immunological tolerance. Immunology letters 2015. link 27 Sherbino J, Kulasegaram K, Howey E, Norman G. Ineffectiveness of cognitive forcing strategies to reduce biases in diagnostic reasoning: a controlled trial. CJEM 2014. link 28 Glass TR, Winzor DJ. Confirmation of the validity of the current characterization of immunochemical reactions by kinetic exclusion assay. Analytical biochemistry 2014. link 29 Labuschagne M, Robbetze W, Rozmiarek J, Strydom M, Wentzel M, Diedericks BJ et al.. Errors in drug administration by anaesthetists in public hospitals in the Free State. South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde 2011. link 30 Valenstein PN, Alpern GA, Keren DF. Responding to large-scale testing errors. American journal of clinical pathology 2010. link 31 Vanker N, van Wyk J, Zemlin AE, Erasmus RT. A Six Sigma approach to the rate and clinical effect of registration errors in a laboratory. Journal of clinical pathology 2010. link 32 Park HW. 'The shape of the human being as a function of time': time, transplantation, and tolerance in Peter Brian Medawar's research, 1937-1956. Endeavour 2010. link 33 Lippi G, Blanckaert N, Bonini P, Green S, Kitchen S, Palicka V et al.. Causes, consequences, detection, and prevention of identification errors in laboratory diagnostics. Clinical chemistry and laboratory medicine 2009. link 34 Yamada Y, Nomura N, Yamada K, Wakamatsu N, Kaneko K, Fujimori S. Molecular analysis of hypoxanthine guanine phosphoribosyltransferase (HPRT) deficiencies: novel mutations and the spectrum of Japanese mutations. Nucleosides, nucleotides & nucleic acids 2008. link 35 Wagar EA, Stankovic AK, Raab S, Nakhleh RE, Walsh MK. Specimen labeling errors: a Q-probes analysis of 147 clinical laboratories. Archives of pathology & laboratory medicine 2008. link 36 Yamada Y, Nomura N, Yamada K, Wakamatsu N. Molecular analysis of HPRT deficiencies: an update of the spectrum of Asian mutations with novel mutations. 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    Original source

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