Chorea and athetosis are movement disorders characterized by involuntary, irregular movements, with chorea involving jerking movements and athetosis featuring slow, writhing motions. Chorea can be hereditary or acquired, with various medical causes including Huntington's disease and drug effects, while athetosis is often linked to conditions like cerebral palsy and jaundice. Treatment for both includes medical management with specific medications, physiotherapy to improve balance and coordination, and lifestyle adjustments to enhance muscle control.

1. AND
ATHETHOSI
S
PRESENTED BY ROLL NO -
04

2. CHOREA - DEFINITION
 An involuntary, irregular, jerking
movement affecting limb and axial
muscle groups. These movements are
suppressed with difficulty and are
incorporated into voluntary gestures
resulting in a ‘semi purposeful’
appearance, e.g. crossing and
uncrossing of legs.
 It is a type of hyperkinetic movement
disorder
 The involuntary movements flow from

3. CAUSES
1)Hereditary – Huntington’s disease, Benign chorea
2)Metabolic – Hyperthyroidism, Hypocalcaemia
3)Drugs – Antiparkinsonian drugs, Oral contraceptives
4)Immunological – Systemic lupus erythematosus,
Polyarteritis nodosa
5)Toxins – alcohol, carbon monoxide poisoning
6)Miscellaneous – Chorea gravidarum, Polycythaemia
rubra vera
7)Infections – Sydenham’s chorea, Encephalitis

4. TYPES OF CHOREA
1) PRIMARY CHOREA (genetical causes)
Primary chorea develops as the result of a disease, of which it
is a primary symptom.
Eg: Hunington’s Syndrome
Primary will be symmetrical symptoms with insidious onset
2) SECONDARY CHOREA (acquired causes)
Drug induced Chorea, Immune mediated Chorea, Infectious
Chorea, Vascular Chorea, Hormonal Disorders
Secondary will be asymmetrical and most of time sudden onset

5. CLINICAL FEATURES
• Fidgeting involuntarily
• Asymmetrical irregular movements
• Inability to maintain an ongoing motor activity, such as maintaining a
constant grip or holding the tongue out
• Abrupt, interrupted speech
• Involuntary vocalization
• Loss of coordinated movements
• Gait disturbance – in the form of jerky movements
• Impaired balance

6. TREATMENT: MEDICAL MANAGEMENT
1. Dopamine-depleting agents: Tetrabenazine,
Deutetrabenazine, Valbenazine.
2. Dopamine D2 receptor-blocking agents: Haloperidol,
Clozapine, Olanzapine.
3. Anticonvulsants: Valproic acid, Carbamazepine,
Benzodiazepines, Levetiracetam.
4. Anti-glutamatergic agents: Amantadine, Riluzole.
5. Cannabinoids: Nabilone.
6. Deep Brain Stimulation

7. PHYSIOTHERAPY MANAGEMENT
• Gait re-education
• Balance retraining
• Fall prevention/management
• Aerobic capacity
• Muscle strengthening
• Wheelchair prescription and training
• Respiratory function
• Task-specific reach, grasp, and manipulation.

8. ATHETOSIS - DEFINITION
• It consists of irregular, repetitive, writhing
movements.
• Athetosis refers to the slow, involuntary, and
writhing movements of the limbs, face, neck,
tongue, and other muscle groups.
• These movements may be continuous, slow, and
rolling. They may also make maintaining a
symmetrical and stable posture difficult.

9. CAUSES
1) Jaundice
2) Birth difficulty – Asphyxia can lead to brain
damage
3) Cerebral Palsy
4) Stroke
5) Drug Toxicity
6) Head Trauma

10. CLINICAL FEATURES
• Slow, involuntary, writhing muscle movements
• Random and unpredictable changes in muscle
movement
• Worsening symptoms with attempts at controlled
movement
• Worsening symptoms with attempts at improved
posture
• Inability to stand

11. TREATMENT- MEDICAL MANAGEMENT
• Anti-dopamine medicines: drugs that suppress the
hormone’s effect on the brain
• Botox injections: treatment that may temporarily
limit involuntary muscle actions
• Lifestyle Management- Changing your lifestyle,
eating healthier, and exercising regularly for muscle
strengthening can help improve the complications
• Occupational therapy: muscle training to regain
some control

12. PHYSIOTHERAPY MANAGEMENT
1) To prevent falls
2) To improve balance and coordination
3) Gait Training
4) Muscle strengthening
5) Task-specific reach, grasp, and
manipulation.

13. T H A N K – Y O
U