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Chorea is the name for a group of disorders that cause involuntary movements or contractions in varying parts of the body. The type present may indicate where body movements occur, though not always. In Huntington’s disease, for instance, jerky body movements may happen with great frequency in the face and in other areas, and these symptoms tend to worsen as the disease progresses. In contrast, Chorea gravidarum, which occurs in pregnancy is usually most noticed in the limbs and face, and in Sydenham’s chorea, mostly the face is affected by a series of uncontrolled facial contractions and grimaces.
There are many things that may cause these uncontrolled movements. As mentioned, Huntington's disease and more rarely pregnancy are indicated. Sydenham’s chorea is almost always associated with rheumatic fever and most likely to affect children. Other causes include certain psychiatric medications or disorders of the metabolism.
Treatment can be different depending on cause. In pregnant women for instance, some treatments have included using anti-psychotic medications like haloperidol (Haldol®), and some benzodiazepine tranquilizers. These may not fully control movements but might eliminate them to some degree. There is great concern about using strong medications in pregnancy because of the possible negative effects on the fetus.
Sydenham’s chorea is usually time-limited, though the disease can last several months. Treatment again might focus on reducing muscle movements through tranquilizers or other drugs, but it may not be a total cure. Fortunately many people recover fully from this condition after a couple of months, and most will not relapse and experience it again. However, it’s challenging for anyone who does have this condition because it usually affects kids between the ages of 7-14, and can be absolutely miserable involuntary movements continue.
While forms of this condition caused by pregnancy or rheumatic fever resolve, Huntington’s chorea doesn’t and the disease is a progressive and devastating one that is inherited genetically. Treatments for chorea symptoms in Huntington’s usually involve raising dopamine levels, which may be accomplished with medications like some monoamine oxidase inhibitors, or with a variety of other medications like L-dopa. Some degree of involuntary muscle movement may still occur despite treatment.
For other types of chorea, treatment is tied to possible cause. For instance, if medications are resulting in symptom of this condition, discontinuing medication or substituting a different medication could be tried. Goal of treating this involuntary movement disorder is twofold in many cases: to determine its cause and to stop the movement.