CHOREA - a form of hyperkinesis; characterized by involuntary, fast, irregular movements that occur in various muscle groups. The term "chorea" is used to mean both independent diseases in which choreic hyperkinesis is a leading manifestation (for example, small chorea, Huntington's chorea), and a number of syndromes that occur with various diseases.
Hyperkinesis of a choreic nature can be a manifestation of many pathological conditions and diseases: focal disorders of cerebral circulation in the area of subcortical nodes, viral encephalitis, lupus erythematosus, polycythemia; can occur with poisoning by carbon monoxide, manganese, carbon disulfide, while taking certain drugs - amphetamine, levodopa, chlorpromazine derivatives. Any external irritations, emotional arousal increase the severity of choreic hyperkinesis, at rest it decreases, and disappears during sleep. With severe hyperkinesis, eating, walking, standing up, etc. become impossible. Involuntary movements, as a rule, develop against the background of muscle hypotension.
Small (or rheumatic) chorea is an acute toxic and infectious disease caused by a rheumatic process. It occurs in childhood or young age, develops gradually. The child becomes awkward, his handwriting changes, fussiness, general anxiety, blurred speech, restless sleep appear. Against this background, involuntary movements with a sufficiently large amplitude and the absence of a certain expediency are noticeable, grimacing is noted. In the advanced stage of the disease, chaotic scattering of arms and legs, twitching of the head are observed, grimacing intensifies, gusty body movements appear. The development of hyperkinesis, as a rule, is combined with general asthenia, increased excitability, emotional instability. On average, small chorea lasts 2 to 4 months. Long and worn-out forms sometimes last up to one year and are prone to relapse.
Chorea can develop during pregnancy in young women who have had small chorea in childhood.
Huntington's chorea is a hereditary disease. Its first signs are manifested at the age of 25-50 years, less often in childhood. Men get sick more often than women. The main symptoms of the disease are choreic hyperkinesis and gradually increasing dementia . Hyperkinetic syndrome is manifested by involuntary grimacing, increased gestures, intentional trembling, staggering when walking. During the conversation, there are grimaces, sighs, smacking lips, tongue, sniffing, making speech difficult. Each step is accompanied by additional movements in the form of waving hands, dancing, squats, nodding, etc. The severity and prevalence of hyperkinesis increases over time. A mental disorder is initially expressed in increased excitability, decreased memory, attention, and only in the subsequent dementia develops.
The clinical manifestations of Huntington's chorea are close to the so-called senile chorea, in which choreic hyperkinesis develops in old age and is accompanied by progressive dementia.
If a patient is suspected of having chorea, they should be referred for a consultation with a neurologist. The most effective method of treating choreic hyperkinesis is taking medications that reduce the activity of the dopaminergic systems of the brain - haloperidol, phenothiazine derivatives, reserpine, etc.