Choreiform Movements (CRM)/ Chorea
Choreiform Movements (CRM)/ Chorea: Understanding Causes, Symptoms, and Clinical Implications
Choreiform movements (CRM)/ Chorea are a type of involuntary movement disorder characterized by brief, irregular, and unpredictable movements that flow from one muscle to another. These movements are often described as “dance-like” and can affect various body parts, including the hands, feet, and face.
Symptoms
Symptoms of choreiform movements include:
- Involuntary Movements: Quick, abrupt movements that cannot be suppressed.
- Fidgeting: Mild intermittent exaggerations of gestures and expressions.
- Impact on Daily Activities: Interference with speech, swallowing, posture, and gait.
- Distinctive Gait: An unusual way of walking that may be recognized by neurologists.
- Milkmaid’s Grip: Difficulty maintaining a steady grip, resulting in a milking motion.
- Jack-in-the-Box Tongue: Involuntary protrusion and retraction of the tongue.
Causes
Choreiform movements can arise from various conditions:
- Huntington’s Disease: A genetic disorder commonly associated with chorea.
- Sydenham Chorea: Linked to rheumatic fever.
- Wilson Disease: A genetic disorder affecting copper metabolism.
- Spinocerebellar Ataxia: A group of genetic disorders affecting coordination.
- Structural Brain Disorders: Conditions affecting the basal ganglia.
Treatment
Treatment focuses on managing symptoms and addressing underlying causes:
- Dopamine-Depleting Agents: Tetrabenazine and deutetrabenazine are used to reduce chorea.
- Antipsychotics: Dopamine D2 receptor blockers like haloperidol can help manage symptoms.
- Anticonvulsants: Valproic acid and benzodiazepines may be used in some cases.
- Multidisciplinary Care: Includes physical therapy, occupational therapy, and speech therapy to improve function and quality of life.
Conclusion
Choreiform movements are a hallmark of several neurological conditions, requiring a comprehensive approach to diagnosis and treatment. Understanding their causes and symptoms is crucial for effective management.
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