The chorea (also chorea is called), a symptom of several diseases, the basal ganglia affect the brain. Typical are (predominantly in the waking state) involuntary, sudden, rapidly occurring, irregular movements of the extremities, face, neck and trunk, which occur both at rest and during voluntary movements.
The term chorea comes from the Greek word "c (h) oreia" ('dance'). With this, Plato called a choir dance consisting of dance, but also dances of madmen, with "Chorea insaniens". The expression was also introduced into medical nomenclature by Paracelsus in the 16th century for the "St. Vitus dance". Sydenham described chorea minor as a pathological mass phenomenon in the 17th century.
In 1872, George Huntington described chorea major as hereditary chorea. Overall, however, the descriptions were very inconsistent, and it was only with the advent of neuropathology and later genetics that the various forms were more precisely distinguished.
Definition of terms
Choreatic movement disorders belong to the large group of extrapyramidal hyperkinesias , which also include tremor , dystonia , ballism or tics in Tourette's syndrome . All extrapyramidal hyperkinesias are based on a malfunction of certain parts of the basal ganglia.
The Chorea (Greek for dance) is not a disease but a purely descriptive term for a symptom, the number of very different causes may underlie. The end result, however, is always a functional disorder of the striatum , which then leads to very characteristic movement disorders .
A distinction must be made between:
- Chorea major (Huntington) : inherited, degenerative chorea, the so-called hereditary St. Vitus dance
- Chorea minor ( Sydenham ): post-infectious autoimmune chorea; Immune-mediated secondary disease affecting children especially after infection with streptococci , often combined with rheumatic fever , see also PANDAS
- Neuroacanthocytosis syndromes ( McLeod syndrome , chorea acanthocytosis )
- Benign hereditary chorea
- Disorders of metabolism (especially hyperthyroidism )
- Collagenoses (e.g. chorea in systemic lupus erythematosus (SLE))
- Wilson disease
- Chorea senilis ( Hemichorea ): affecting the right or left half of the body as a consequence of a stroke or on both sides due to insufficient blood supply to the brain
- Chorea gravidarum : especially in women who are pregnant for the first time, possibly a subtype of chorea minor
- Medication-induced chorea (e.g. L-Dopa overdose in the treatment of Parkinson's disease ; the tuberculosis drug isoniazid ; some birth control pills; some neuroleptics ; anticonvulsants )
- Rare: in multiple sclerosis
- Chorea electrica in Dubini syndrome ( Henoch syndrome , Bergeron-Henoch disease )
- Neurological status
- Neuropsychological status
- psychiatric examination
- Determination of ceruloplasmin -spiegels in serum
- Thyroid levels
- Collagenosis diagnostics
- Acanthocytes on a blood smear
- Investigation of the genetic defect
and possibly still
- Cerebral imaging ( cCT , c MRI or positron emission tomography (PET) )
- Neurophysiological examinations ( somatosensitive evoked potentials (SEP) , blink reflex , electronystagmography )
- Examination of the cerebrospinal fluid
Determination of heavy metals in serum and / or urine
- "B. Holdorff: Historical Aspects of basal ganglia disorders and movement disorders. In: Neurology journal for interdisciplinary training.. Volume 34, May 2015, pp 335-342.
- Barbara I. Tshisuaka: Dubini, Angelo. In: Werner E. Gerabek , Bernhard D. Haage, Gundolf Keil , Wolfgang Wegner (eds.): Enzyklopädie Medizingeschichte. De Gruyter, Berlin / New York 2005, ISBN 3-11-015714-4 , p. 324.