Chorea is a movement disorder characterized by involuntary, irregular muscle movements that can resemble dancing, often indicating underlying neurological issues like Huntington's disease. Symptoms may include fidgety movements, slurred speech, and coordination problems, while diagnosis involves blood tests and imaging studies. Treatment options range from medications to manage symptoms to surgical interventions like deep brain stimulation, along with nursing management to prevent injuries and support daily living activities.

1. Chorea

2. INTRODUCTION
• the word chorea comes from the Greek word for
“dance”) or look restless or fidgety.
• Chorea is a movement problem that occurs in many
different diseases and conditions. Chorea itself isn’t
life-threatening, but it could be a sign of a
neurological disease such as Huntington’s disease.
• Doctors can prescribe medication to control the
abnormal muscle movements. Depending on the
underlying cause, chorea may be temporary or be
ongoing and get worse over time.

3. DEFINITION
• Chorea is a movement disorder that causes
involuntary, irregular, unpredictable muscle
movements. The disorder can make you look
like you’re dancing .

4. MOVEMENTS
Types of movement
Athetosis Ballismus

5. Athetosis
a continuous stream of slow,
twisting or squirming-like
motions usually involving the
hands and feet.
Ballismus
involves more intense
movements such as wild flinging
of one arm or leg. Usually the
movements only affect one side
of the body

8. RISK FACTORS
• People with a family history of Huntington’s
disease
• Children who have had rheumatic fever
• People with other medical conditions

9. CAUSES
• Huntington’s disease
• Rheumatic fever
• Other infectious diseases (Rarely)
• Autoimmune diseases
• Stroke
• Pregnancy
• Endocrine and metabolic disorders
• Medications
• Toxins
• Older age

10. PATHOPHYSIOLOGY

11. SYMPTOMS
•Also called fidgety movements or dance-like movements
usually appear in the hands, feet, and face.
•They can affect the way you walk, swallow and talk
•The movements may be fluid or somewhat jerky.
Involuntary
muscle
movements
•Rather than holding your hand steady when you try to shake
someone’s hand, you may grip and release your fingers over and
over again.
•Doctors call this symptom milkmaid’s grip because it looks like
you’re milking a cow
Milkmaid’
s grip
•When you try to stick out your tongue, it may slide
in and out of your mouth. This sign of chorea is
sometimes called jack-in-the-box tongue or
harlequin tongue.
Jack-in-the-
box tongue

12. •Kids and adults may
develop slurred speech
as the muscles involved
in making speech lose
coordination.
Speech
proble
ms
•Kids who develop chorea after
rheumatic fever can have
seizures and headaches.
•Some children also have
behavioral and emotional
issues.
Headac
hes and
seizures

13. DIAGNOSIS AND TESTS
Blood
tests
• To check for infections, lupus
thyroid levels or other endocrine
or metabolic abnormalities.
Imaging
studies
• Magnetic resonance imaging (MRI)
scan
• Computed Tomography (CT) scan
• To look for changes in your brain.
Genetic
testing
•To see if you have the gene
for Huntington’s disease.

14. PHARMACOLOGICAL MANAGEMENT
Dopamine-
depleting
agents
•Tetrabenazine,
•Deutetrabenazine,
•Valbenazine.
Antidepre
ssants
• Citalopram (Celexa)
Anticonvu
lsants
•Valproate (Depacon)
•Carbamazepine (Carbatrol)
Antipsych
otics
• Quetiapine (Seroquel)
• Risperidone (Risperdal)
• [suppress violent outbursts,
agitation.]

15. Anti-
Glutamatergic
agents
•Amantadine
•Riluzole
Corticost
eroids
• To help control the movements
Antibiotics • To kill the rheumatic fever infection.
Deep Brain
stimulation
•
A surgical procedure used to treat
several disabling neurological symptoms

16. NURSING MANAGEMENT
• Prevent injury and possible skin breakdown
Pad the sides and head of the bed
Keep the skin meticulously clean
Encourage ambulation with assistance
to maintain muscle tone
Secure the patient in bed or chair with padded
protective devices making sure they are
loosened frequently.

17. • Keep patient as close to upright as possible while
feeding. Stabilize patient’s head gently with one hand
while feeding
• The nurse needs to educate and support the patient
and family as they adjust to the lifestyle changes that
are required.
• The actions and potential side effects of medication
regimen need to be taught, monitored and adjusted to
the desired patient response.
• Regular moderate exercise can reduce stiffness and
tremors.
• As the disease progresses, the patient and family will
require more assistance with activities of daily living,
emotional support, and potential financial concerns

18. NURSING DIAGNOSIS
• Risk for injury from falls and possible skin breakdown
(pressure ulcers, abrasions), resulting from constant
movement
• Imbalanced nutrition: less than body requirements due to
inadequate intake and dehydration resulting from
swallowing or chewing disorders
• Risk for aspiration related to swallowing difficulty
• Anxiety and impaired communication from excessive
grimacing and unintelligible speech
• Disturbed thought processes and impaired social interaction