What is the difference between chorea and dyskinesia?

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Scientists define dyskinesia as any state of involuntary movement. Chorea is a type of dyskinesia.

There are several types of dyskinesia, other than chorea, which include:

• myoclonus
• dystonia
• akathisia
• tics

These types of dyskinesia differ in their symptoms, causes, treatment, and outlook.

The movements associated with chorea can be:

• exaggerated
• abrupt
• dynamic
• nonrepetitive
• irregular
• seemingly random

When someone has chorea, these involuntary movements can affect the whole body. They can also affect individual body parts, such as the hands or face.

As with chorea, dyskinesia can affect either the whole body or specific body parts.

All dyskinesias involve involuntary movement. However, there are important differences between these movements.

Chorea

In chorea, involuntary movements are typically dynamic, unstable, and highly irregular.

The term chorea describes movements that can sometimes resemble dancing. However, someone with chorea does not control these movements, which can constitute serious impairments.

Dyskinesia

Symptoms of dyskinesia vary from case to case:

• Myoclonus: Scientists define myoclonus as jerky, shock-like involuntary movements. These movements are rapid and brief and can affect muscles all over the body.
• Dystonia: Researchers define dystonia as involuntary muscle contractions. This leads to unusual posturing and twisting motions. It can also cause repetitive movements and tremors.
• Akathisia: Akathisia is the inability to remain still. Research shows that it begins with an intense sensation of inner restlessness. This causes a compulsion to move, often in a repetitive fashion.
• Tic disorders: Tic disorders, such as Tourette’s syndrome, can cause involuntary movements. Scientists suggest these movements are rapid and recurrent but not rhythmical. Most commonly, they affect the neck, head, or face.

There are important similarities and differences in the causes and risk factors of dyskinesia.

Chorea

Several diseases can cause chorea, including:

• Huntington disease, a hereditary brain disorder
• Wilson disease, a genetic condition affecting copper levels in the body
• rheumatic fever, a rare complication that can develop after a bacterial throat infection
• spinocerebellar ataxia, a degenerative disease that affects movement
• hyperthyroidism, a condition in which the thyroid produces too many thyroid hormones
• hypoglycemia, which refers to low blood pressure
• hypomagnesemia, which refers to low levels of magensium in the blood
• strokes
• brain tumors

Some drugs and medications can also cause chorea. They include:

• levodopa, a medication to treat Parkinson’s disease
• oral contraceptives
• neuroleptics
• antihistamines
• amphetamines
• cocaine

The risk factors for chorea are the combined risk factors for its possible causes and are highly varied. Overall, however, chorea most commonly develops in people between the ages of 30 and 40 years.

Dyskinesia

There are various causes and risk factors for dyskinesia:

• Myoclonus: Research suggests myoclonus can arise for many different reasons. For example, the condition is present in some people who have seizure disorders. In contrast, myoclonus when falling asleep is common in the general population.
• Dystonia: Scientists do not yet know the cause of dystonia, although there appears to be a strong genetic component. Various factors can worsen symptoms of dystonia, including stress, anxiety, fatigue, and disrupted sleep.
• Akathisia: Although scientists remain uncertain about the exact causes of akathisia, this condition only arises from drug use. Research suggests that this may occur when drugs block dopamine receptors. Antipsychotics, antidepressants, and cocaine can all lead to akathisia.
• Tic disorders: Scientists continue to investigate the causes of tics. There is good evidence that genetics play a role. Risk factors include being male, infections, autoimmune problems, and perinatal injuries.

Medications can cause every type of dyskinesia. When dyskinesia arises from taking medication, scientists call it tardive dyskinesia.

Doctors have several methods for treating dyskinesia.

Chorea

Research shows that certain medications can help some individuals reduce their chorea. For the most part, these medications are dopaminergic agents, which block dopamine receptors.

Other pharmaceutical treatment options include:

• valproate
• clonazepam
• gabapentin

In some cases, chorea can arise after a heart transplant. When this is the case, some steroids can help with chorea.

Dyskinesia

Some treatment options for chorea are similar to those of certain other dyskinesias. Doctors can treat dyskinesias in the following ways:

• Myoclonus: There is evidence that certain medications, such as valproate, clonazepam, and levetiracetam, can help with some types of myoclonus. In other types of myoclonus, Botulinum toxin may be useful.
• Dystonia: Research indicates that dopaminergic agents and Botulinum toxin can also help with dystonia. Other useful medications include trihexyphenidyl, baclofen, and benzodiazepines.
• Akathisia: According to a recent review, scientists remain unsure about how best to treat akathisia. When the condition arises as an adverse effect of antipsychotic usage, reducing the dose or changing the medication can help. Beta-blockers may also have a positive effect, although this remains unclear.
• Tic disorders: There is evidence that behavioral therapies can greatly help many people control their tics. Habit-reversal therapy is one effective example. However, some individuals may require pharmaceutical treatment. This will usually involve an alpha-2-adrenergic agonist, or an antipsychotic.

The outlook for these conditions varies.

Chorea

According to the 2022 review, the outlook for chorea depends upon its underlying cause. For instance, the outlook for people with Huntington’s disease is negative. This condition can cause significant reductions in quality of life and premature death.

In other cases, chorea may have a more positive outlook. For example, Sydenham chorea, which develops in children as a result of rheumatic fever, typically resolves within 3–6 weeks.

Dyskinesia

There are several differences in the outlooks for other dyskinesias.

• Myoclonus: Research shows that the outlook for myoclonus varies from case to case. For example, in tardive myoclonus, the condition can completely resolve with a change of drug treatment.
• Dystonia: Generally, scientists believe that people with dystonia have a reduced quality of life. However, unlike chorea, dystonia does not typically reduce a person’s life expectancy.
• Akathisia: When it comes to akathisia, the outlook is highly dependent upon treatment. There is evidence that the outlook tends to be positive if the individual stops taking the drug that is causing akathisia. However, without treatment, the outlook for akathisia is negative. It sometimes also leads to suicidal ideation.
• Tic disorders: The outlook for people with tick disorders varies. Research suggests that around one-third of people with tic disorders recover completely. Another third of individuals show some improvements in their symptoms. The final third of people with tic disorders show no such improvements.

Dyskinesias are movement disorders that involve involuntary movements. Chorea is a type of dyskinesia that involves abrupt and unpredictable movements.

There are many similarities and differences between different kinds of dyskinesia.

The treatment and outcomes vary depending on the type of dyskinesia a person has.