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What causes chorea? 13 possible conditions

What Is Chorea?

Chorea is a condition that causes involuntary, unpredictable body movements that do not have a pattern. Chorea symptoms can range from minor movements such as fidgeting to profound, uncontrolled movements of the arms and legs.

Types of Chorea

Medical experts consider chorea to be one of three types of hyperkinetic disorder. Chorea causes rapid involuntary motions. Ballismus (or choreoballismus) causes more-severe jerking motions that are more likely to cause injury. Athetosis (or choreoathetosis) causes slow, writhing movements.

What Causes Chorea?

Chorea is associated with a number of causes, some temporary and some chronic. Examples of chorea causes include:

  • AIDS
  • genetic conditions, such as Huntington’s disease
  • immune conditions, such as systemic lupus erythematosus
  • infection-related conditions, such as Sydenham’s chorea, which is the result of rheumatic fever
  • medications, including levodopa and neuroleptics
  • metabolic or endocrine disorders, including hypoglycemia
  • pregnancy (known as chorea gravidarum)

Because many conditions cause chorea, a doctor must take a thorough medical history to determine potential causes.

What Are Risk Factors for Chorea?

Patients with a history of rheumatic fever are more likely to experience chorea. This risk factor makes pregnant women more likely to have chorea gravidarum.

Other risk factors are related to individual risk for disease. For example, Huntington’s disease is a hereditary disorder. Huntington’s disease may cause chorea. A person with a parent who has Huntington’s disease has a 50 percent risk of having the disease as well (Mayo Clinic, 2011).

What Are the Symptoms of Chorea?

Chorea symptoms usually depend upon the condition causing it. A common symptom is the “milkmaid” grip. This grip looks as if a person is holding an eating utensil, but the thumb is pointing upward. Another symptom is involuntarily sticking out the tongue.

The movements can be fast or slow. A patient may appear to be writhing in pain and to have no bodily control.

Chorea symptoms depend on the underlying cause:

Huntington’s Disease

Huntington’s disease patients may think that initial chorea symptoms are clumsiness or nervousness. Chorea is a more common symptom in people with adult-onset Huntington’s disease than in patients who were diagnosed as children. Over time, the symptoms worsen and movements affect the legs and arms.


This condition is a genetic disorder that affects brain functioning. Chorea for this condition commonly starts as lip or tongue biting, due to the tongue sticking out.

Sydenham’s Chorea

This condition is the result of rheumatic fever. Patients with this chorea type often display milkmaid grip. Another common symptom is “harlequin tongue.” This occurs when a patient tries to consistently stick the tongue out, but the tongue pops in and out instead.

How Is Chorea Diagnosed?

Chorea diagnosis primarily consists of taking a thorough medical history and conducting a clinical exam. To diagnose chorea, your doctor may ask:

  • When did the symptoms begin?
  • What makes the symptoms worse or better? (Chorea symptoms tend to worsen when a patient is stressed.)
  • Do you have a family history of hyperthyroidism or Huntington’s disease?
  • What medications are you currently taking?

Some laboratory tests can indicate chorea. For example, a low copper level can indicate Wilson disease, a genetic disorder that causes chorea. Tests for spiky erythrocytes or red blood cells can indicate neuroacanthocytosis. Blood test for parathyroid hormones or thyroid hormones can indicate metabolic or endocrine-related chorea. 

Imaging studies, such as a magnetic resonance imaging (MRI) scans, can show brain activity. These can indicate Huntington’s disease.

How Is Chorea Treated?

Chorea treatments depend upon the type of chorea a person has. For example, Sydenham’s chorea is treated and cured with antibiotics. Chorea due to Parkinson’s disease has no cure. Medications may treat an underlying condition, and this will help with chorea symptoms.


Most medications for chorea affect dopamine. Dopamine is a neurotransmitter, or brain chemical, that controls movement, thinking, pleasure, and more. Many movement disorders, including Parkinson’s disease and restless legs syndrome, are associated with dopamine levels.

Some medicines block dopamine receptors so the body cannot use the chemical. They are in the “antipsychotic” category and seem to reduce chorea. These include:

  • fluphenazine (Prolixin)
  • haloperidol (Haldol)
  • olanzapine (Zyprexa)
  • quetiapine (Seroquel)
  • risperidone (Risperdal)

Other drugs reduce the amount of dopamine in the brain. These include reserpine and tertrabenazine (Xenazine). Medications known as benzodiazepines also may help to reduce chorea. These include clonazepam and Klonopin. 

The last medication class associated with reducing chorea is anticonvulsants, which reduce spontaneous movements and include.


Deep brain stimulation is a surgical approach that shows promise for chorea treatment. This treatment involves implanting electrodes in the brain to regulate nerve impulses. If chorea does not respond to medications, a doctor may recommend deep brain stimulation. This procedure does not cure chorea but can reduce symptoms.

Home Care

Chorea increases a person’s likelihood for falls. Home care measures may include installing non-slip surfaces on stairs and in bathrooms to prevent injury.

What Is the Outlook for Chorea?

The outlook for chorea depends on the condition causing it. Antibiotics can cure Sydenham’s chorea, while there is no cure for Huntington’s disease.

Women with chorea gravidarum typically stop having symptoms up to six weeks after giving birth. People with metabolic or endocrine-related chorea typically stop having symptoms once a doctor treats the imbalance.

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See a list of possible causes in order from the most common to the least.


Huntington's Disease

Huntington's disease is a hereditary condition in which the brain's nerve cells gradually break down. This affects physical movements, emotions, and cognitive abilities. There is no cure, but there are ways to cope wit...

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Rheumatic Fever

Rheumatic fever is a possible and potentially serious complication of strep throat. It tends to occur in children between five and 15 years old. Rash is one possible sign of this condition.

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This condition is considered a medical emergency. Urgent care may be required.

Encephalitis is an inflammation of the brain tissue. It's most often caused by viral infections. In some cases, bacterial infections can cause encephalitis.

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Stroke Overview

This condition is considered a medical emergency. Urgent care may be required.

A stroke (a "brain attack") is a medical emergency in which part of the brain is deprived of oxygen. This occurs when an artery that supplies oxygenated blood to the brain becomes damaged and brain cells begin to die.

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Intracerebral Hemorrhage

This condition is considered a medical emergency. Urgent care may be required.

Intracerebral hemorrhage (ICH) is when blood suddenly bursts into brain tissue, causing damage to the brain. Symptoms usually appear suddenly during ICH.

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Kuru is an extremely rare and fatal nervous system disease. The disease reached its peak during the 1950s and 1960s among the Fore people in the highlands of New Guinea. The Fore people contracted the disease b...

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Systemic Lupus Erythematosus

Systemic lupus erythematosus (SLE) is an autoimmune disease and the most common type of lupus. One of its common symptoms is a rash on the cheeks and nose called a "butterfly rash."

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Lyme Disease

Lyme disease is an infectious condition transmitted via tick bite. A "bull's eye" rash at the site of the bite is an early symptom of this disease.

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Wilson's disease

Wilson's disease, also known as hepatolenticular degeneration, is a rare genetic disorder caused by the buildup of copper. Small amounts of copper exist in the body and are released through the urine. In Wilson'...

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Calcium Deficiency Disease (Hypocalcemia)

A lack of calcium can lead to diseases like osteoporosis and calcium deficiency disease (hypocalcemia). Severe deficiency can result in numbness and tingling in the mouth, lips, hands and feet, among other signs.

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Polycythemia Vera

Polycythemia vera is a disorder in which the body produces an excessive amount of red blood cells. This can lead to clots, which block blood from reaching the heart or brain, causing serious damage.

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The thyroid gland produces a hormone that controls how your cells use energy. Hyperthyroidism occurs when the body produces excessive amounts.

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Creutzfeldt-Jakob Disease and Mad Cow Disease

Creutzfeldt-Jakob disease is an infectious disease that causes the brain to degenerate. The hallmark of this brain disease is an inability to think clearly and take care of oneself.

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This feature is for informational purposes only and should not be used to diagnose.
Please consult a healthcare professional if you have health concerns.