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Chore is the uncoordinated, dance-like movement that usually involves the limbs. The cause of these involuntary movements can be both inherited genetic disorders and the use of certain medications or even … pregnancy. Whether chorea can be cured depends on the underlying problem - in some cases it is possible to treat it effectively, in others, unfortunately, medicine is helpless.
Chore movementsis one type of involuntary movement. Their name comes from the Latin word choreus, meaning dance. In fact, these movements do resemble dancing, since the essence of chorea is the appearance of the involuntary, "flowing" movements of certain parts of the patient's body. Chore's movements are uncoordinated, they appear unexpectedly and are impossible to control.
The main cause of chorea is disturbance in the amount of one of the brain's neurotransmitters - dopamine. Its excess affecting the structures that regulate motor activities (e.g. the basal ganglia) can lead to the occurrence of chorea in patients. Usually the causes of chorea are hereditary diseases, such as:
- Huntington's disease
- some types of spinocerebellar ataxia
- diseases related to the accumulation of iron within the structures of the central nervous system
- Wilson's disease
- Friedreich's ataxia
- Rett syndrome
- mitochondrial diseases
Apart from the above-mentioned genetic causes, the cause of chorea may also be disorders that appear during the patients' lives. The causes of chorea can be:
- medications used by patients (e.g. hormonal contraceptives, levodopa, antiepileptics and antipsychotics)
- complications of having a streptococcal infection (so-called Sydenham's chorea is then recognized)
- HIV infection
- strokes within the brain (especially those involving the basal ganglia)
- pregnancy (involuntary movements that occur during this period are referred to as chorea of pregnant women)
- systemic lupus erythematosus
- antiphospholipid syndrome
- transmissible spongif.webporm encephalopathies
The diagnostic test that will be performed to identify the cause of chorea depends on the suspected etiology of the problem. In the case of patients with suspected genetic causes of the problem, genetic tests can be performed to detect the existence of specific mutations in their genetic material. Other diagnostic procedures include blood tests, consisting in determining the indicators of HIV infection or detecting the possible presence of antiphospholipid antibodies. Imaging tests can also be used in the diagnosis of chorea. They are especially useful in those patients who develop chorea late in life for no apparent reason. In such a situation, imaging diagnostics may allow to visualize, for example, changes in the brain caused by a stroke.
The chorea movements themselves are not treatable - they are a symptom, so they treat the conditions that caused the involuntary movement to occur. If the medications used by the patient were the cause of chorea, just stopping them may lead to the resolution of the problem. In the case of chorea in pregnant women, there may even be a spontaneous remission of the disease. The treatment of genetic diseases, one of the symptoms of which is chorea, is slightly different. Unfortunately, only symptomatic treatment, not causal treatment, is available for these entities. For example, in patients with Huntington's chorea, the use of antipsychotics by patients may reduce the frequency of the appearance of chorea (these agents are antagonists of dopaminergic receptors, and it is the excessive amounts of dopamine in the nervous system that can lead to chorea).
The prognosis of patients with chorea depends on the cause of these involuntary movements. The prognosis for Huntington's chorea is poor: the course of this disease worsens over time, and only symptomatic treatment is currently known. This is not the case with other conditions that cause chorea: in cases where the involuntary movements have arisen in connection with drug therapy, they may subside, as already mentioned, after the use of such drugs is discontinued. A similar situation applies to Sydenham's chorea, which - thanks to the available treatments for this disease - may subside, and with it, chorea may also disappear.About the authorBow. Tomasz NęckiGraduate of the facultyat the Medical University of Poznań. An admirer of the Polish sea (most willingly strolling along its shores with headphones in his ears), cats and books. In working with patients, he focuses on always listening to them and spending as much time as they need.
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