Athetosis and chorea are two types of involuntary movements that can occur in children and adults with neurological conditions, such as cerebral palsy. The movements have different features, and the most noticeable difference is that athetosis appears slower.

Both conditions are types of hyperkinetic movement. Hyperkinetic movements refer to any excessive or unwanted movements in the muscles. They often occur in people with neurological disorders.

Athetosis is often described as involuntary, writhing movements. Chorea refers to movements that are irregular, excessive, and involuntary that can range in severity from limb movements to potentially disabling movements that affect walking gait.

This article reviews what athetosis and chorea are, their symptoms, similarities, differences, and more.

Blurred motion of a hand holding reading glasses. Athetosis and chorea are both involuntary movements.Share on Pinterest
Photographer, Basak Gurbuz Derman/Getty Images

Athetosis involves slow, continuous movements that prevent a person from achieving a stable posture.

The movements are generally smooth and appear at random. They can worsen with attempted movement or occur when the person is at rest.

Symptoms

Possible symptoms and signs of athetosis may include:

  • involuntary, slow, writhing muscle movements
  • symptoms worsen when attempting to perform a controlled movement
  • unpredictable and random changes in muscle movement
  • attempts to improve posture may worsen movements
  • trouble standing or talking

An older review states that the term “athetosis” comes from the Greek word that means “without place or position.” The use of the term refers to a person’s inability to maintain a stable posture.

Chorea refers to irregular, involuntary movements that can range in severity from gentle to intense to disabling.

The term references “choreography” because experts describe the movements as sometimes appearing like dance movements.

Symptoms

Chorea is not usually the only or first symptom a person may develop. It can develop when a person has a congenital neurological disorder, such as cerebral palsy, or a movement disorder, such as multisystem atrophy. It can also occur as a medication side effect.

A person or their caregivers might notice the movements, and often they will already have been instructed to keep an eye out for the symptoms.

Sometimes chorea can come on gradually. The person and their support network might not recognize that it is that different than the underlying movements (such as the tremors of Parkinson’s or the spasms of cerebral palsy) at first. They may only recognize the difference when the movements worsen.

A person may have trouble holding objects even while concentrating on the task. Chorea can cause the muscles responsible for gripping an object to open and close the hand when a person tries to focus on holding something.

Other possible signs or symptoms include:

  • decreased control of tongue movements, which can lead to difficulty speaking or swallowing
  • changes in behavior
  • cognitive changes
  • any muscles in the body being affected

Athetosis and chorea are both types of involuntary muscle movements. These movements can affect a person’s posture and their ability to perform certain muscle movements.

In both cases, movements may worsen when attempting to move or control muscles. Both may also result from injury or changes to the basal ganglia, as well as medication, peripheral neuropathy, or injury to other brain parts.

A person may experience both movements at different times as part of their condition or both movements at the same time, which is known as choreoathetosis.

The movements have some similarities, which can make telling them apart very difficult for a person or healthcare professional. Several experts describe athetosis as essentially a slower form of chorea.

With athetosis, the same parts of the body may be repeatedly involved. With chorea, the movements are nonrepetitive and randomly distributed throughout the body.

An older review of different muscle movements suggests that the difference between the two movements lies more in the nature of the movement compared to the speed of rhythmicity of the movement.

Several potential causes can lead to athetosis or chorea.

Chorea and athetosis can both occur with athetoid cerebral palsy, also known as dyskinetic cerebral palsy. This condition results from damage to the basal ganglia, which is the part of the brain responsible for regulating voluntary movements, and other parts of the brain in infancy.

We discuss other potential causes of both conditions below.

Athetosis causes

Causes of athetosis can vary by age.

In children, likely underlying causes include early injury to the basal ganglia or other brain areas. Conditions that cause chorea in childhood can include:

  • cerebral palsy
  • encephalitis due to inflammation
  • severe infection
  • head and neck trauma

In adults, athetosis can occur due to severe distal sensory loss. It is known as pseudoathetosis in these cases.

Other causes can include:

  • Parkinson’s disease
  • side effects of drugs used to treat mental health conditions
  • stroke
  • head and neck trauma
  • hepatic encephalopathy
  • pregnancy
  • genetic diseases
  • encephalitis

Occasionally, two variables may interact to cause athetosis, such as brain damage and medication, when one might not cause it otherwise.

Chorea causes

Chorea frequently occurs with Huntington’s disease, but several other disorders and underlying genetic conditions can lead to the condition.

These include:

Other causes may include:

The condition can start at any age, but the age of onset can differ with various conditions.

Younger adults and children often develop chorea due to inflammatory-, infectious-, or trauma-related causes. Chorea due to Huntington’s disease typically occurs when a person is in their 40s or 50s.

Both chorea and athetosis typically occur in conjunction with other underlying conditions and diseases. If the underlying cause is not already known, a person presenting with sporadic movements will likely need a full examination.

A healthcare professional may:

  • review full personal and family medical histories
  • perform an examination and test motor skills
  • order imaging tests, such as an MRI scan, of the brain or other areas
  • order blood tests

Treatment cannot cure either symptom, but it may help manage symptoms and muscle movements as well as address any underlying cause.

Healthcare professionals may use the following anticonvulsants to treat chorea:

Medications can help reduce symptoms, but it is important that a person considers that they may have side effects. Talking with a healthcare professional to learn more about side effects can be helpful.

Newer treatments, such as deep brain stimulation and neural cell transplantation, are still undergoing research but may help people in the future better manage their symptoms.

Here are some frequently asked questions about chorea, athetosis, and other movement disorders.

What is choreoathetosis?

Choreoathetosis describes when chorea and athetosis occur at the same time.

The two movement conditions can both occur with athetoid cerebral palsy, also known as dyskinetic cerebral palsy.

What is the difference between chorea and ataxia?

Chorea and ataxia can both affect muscle movements, but chorea causes involuntary movements, while ataxia causes impaired coordination. The involuntary movements associated with ataxia often result in slurred speech, stumbling, lack of coordination, and falling.

Chorea often develops due to basal ganglia damage, while ataxia typically occurs as a result of damage to the cerebellum.

Athetosis and chorea are two similar symptoms that both cause involuntary movements. These movements can affect a person’s posture and mobility.

They are typically the result of an underlying condition or issue. Both athetosis and chorea can also result from injury to the basal ganglia, medication, or injury to other brain parts.

Similarly, diagnosing and treating both typically involve determining the underlying cause and treating it along with providing symptom relief when possible.