Dystonia and chorea both describe sudden, involuntary movements associated with neurological disorders. However, people with dystonia display repetitive movements that follow a pattern while chorea movements are random.

The National Institute of Neurological Disorders and Stroke (NINDS) explains that people with dystonia often twist into uncomfortable positions and abnormal, often painful, postures, sometimes for hours at a time.

NINDS adds that people with chorea experience more fleeting movements that seem to flow from one muscle group to the next.

This article looks at the similarities and differences between dystonia and chorea. It also explains the causes and risk factors associated with the disorders and looks at the available treatments.

Two people with dystonia and chorea moving rapidly. Share on Pinterest
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The following table looks at some differences between dystonia and chorea.

Dystonia Chorea
involuntary muscle contractions that twist the person’s body into unusual positionsfleeting movements that may flow from one muscle group to the next
movements may be repetitive and follow a pattern movements are random
movements may last for hoursmovements may be brief and jerky
results from the malfunctioning of the basal gangliaresults from dopamine overactivity
a person can inherit or acquire it, or there may be no known causeusually results from an underlying condition, such as Huntington’s disease
treatment aims to relieve symptoms but is not curative some types, such as Sydenham or drug-induced chorea, may be curable

The National Organization for Rare Disorders (NORD) explains that there are different types of dystonia, but that they all involve involuntary muscle contractions that twist the person’s body into unusual positions.

The contractions may be intermittent or sustained.

People with dystonia can experience these muscle contractions anywhere in the body, including the neck, legs, arms, hands, feet, torso, face, eyelids, and vocal cords.

Dystonia usually affects the same group of muscles, and people adopt similar postures during each episode. The symptoms vary in severity from mild to completely debilitating.

NORD identifies four different types of dystonia:

  • Focal: This affects only one part of a person’s body.
    • Task-specific: A type of focal dystonia when a person’s symptoms only occur after a repetitive activity, for example, a writer’s cramp.
  • Generalized: This type affects more than one part of the person’s body.
  • Segmental: Affects two or more adjacent body parts, such as the neck and arm on one side.
  • Multifocal: This affects two or more body parts that are not adjacent, for example, the arm and leg on opposing sides of the body.

According to NINDS, chorea describes uncontrolled, irregular, jerky, movements that do not usually last long. Typically, the movements disappear when the person is asleep.

Chorea is usually a symptom of an underlying illness and is a characteristic symptom of Huntington’s disease, and some metabolic and thyroid diseases.

Chorea can also be a side effect of some medications. These include some anti-convulsants, some antipsychotics, and levodopa, which doctors prescribe to treat Parkinson’s disease.

Dystonia and chorea are both neurological disorders that result in people making involuntary movements.

The biggest difference between them is that people with chorea make random movements, while people with dystonia usually move more predictably.

The duration of the movement also differs. Movements with chorea are usually brief and jerky, while dystonic movements can last for hours, according to the Dystonia Medical Research Foundation (DMRF).

According to the American Association of Neurological Surgeons (AANS), dystonia results from the malfunctioning of the basal ganglia, the part of the brain that coordinates and controls movement.

Chorea results from dopamine overactivity in areas of the brain that control movement.

Symptoms for both dystonia and chorea vary from mild to severe.

They also vary depending on the part of a person’s body they affect.

Some of the more common symptoms of dystonia may include:

  • foot cramps, often making the person’s foot turn inward
  • changes in how a person walks or runs
  • displaying a “dragging leg,” especially after walking a long distance
  • difficulty speaking
  • twisting of limbs that follows a regular pattern over time
  • rapid and uncontrollable blinking

While chorea shares some of these symptoms, NINDS points out that the duration of the muscle contractions is shorter and more random.

Other symptoms of chorea include:

  • appearing restless or fidgety
  • an unstable gait, leading to dance-like movements
  • exaggerated gestures
  • muscle contractions that seem to flow from one muscle to the next

Basal ganglia malfunction causes symptoms for both dystonia and chorea, but genetics and environmental factors can also play a part.

Chorea is a key feature of Huntington’s disease, a genetic condition where toxic proteins build up in a person’s brain. NINDS adds that some people with rheumatic fever develop a type of chorea called Sydenham chorea.

People with thyroid diseases may also have an increased risk of developing chorea.

Doctors use the term “acquired dystonia” to describe symptoms that result from environmental features. NINDS says these can include:

Professionals usually associate chorea with an underlying disease, and doctors can ease its symptoms while treating the cause.

NINDS notes that while Huntington’s disease is progressive and doctors cannot cure it, they can treat Sydenham chorea with antibiotics.

If a person’s chorea is drug-related, doctors can treat the symptoms by adjusting the prescription for the medications.

Doctors can only ease the symptoms of dystonia, and the treatment options depend on the severity of these. According to NINDS, these include:

  • injections of botulinum toxin (Botox) to stop muscle contractions in focal dystonia
  • medications that block different chemicals in the brain
  • surgery to implant electrodes into the parts of the brain that control movement
  • speech therapy
  • physical therapy, to improve a person’s posture
  • mechanical devices, such as splints, to hold a person’s limbs in alignment

Although there are no specific tests to diagnose dystonia or chorea, doctors will look at a person’s family history and medical records.

They may recommend genetic testing to determine if the person has an inherited condition.

NORD says that doctors sometimes recommend people see a movement disorder specialist, particularly for dystonia, as some types have characteristic symptoms.

Doctors may still recommend tests to help them rule out other conditions. These may include blood tests and MRI scans to rule out tumors.

The outlook for people with chorea and dystonia depends on the underlying condition or type.

If Hungtington’s disease causes a person’s chorea, the symptoms are likely to continue as the disease progresses.

People with dystonia may only have mild and intermittent symptoms, to begin with. These can become more severe and longer-lasting over time.

Sometimes, involuntary movements cause fixed postures.

This section answers some frequently asked questions about dystonia and chorea.

What is the difference between chorea and athetosis?

Doctors describe athetosis as an involuntary writhing movement that is slow but continuous. The movements are similar to chorea, but slower, less jerky, and often involve more twisting.

People with athetosis may find it difficult to hold their posture and may appear unstable.

Some people with chorea also have athetosis.

Does a person with dystonia or chorea have tics?

The Centers for Disease Control and Prevention (CDC) defines tics as sudden involuntary movements, sounds, or twitches.

They are different from dystonia and chorea movements in that they often follow a predictable pattern, with different tic movements regularly following each other.

Characteristically, each tic takes the same length of time every time it happens.

Doctors more commonly associate tics with Tourette’s syndrome and obsessive-compulsive disorder.

What is the difference between dystonia and dyskinesia?

Dyskinesia is a medical term for any involuntary and uncontrollable movement disorder.

Both dystonia and chorea are types of dyskinesia.

Dystonia and chorea are neurological disorders with characteristic involuntary muscle movements.

People with dystonia often find the movements pull their posture out of alignment, leaving them twisted in unusual positions. Repeated episodes follow similar patterns, with the person ending up in the same position each time.

People with chorea do not usually experience movement patterns, and the movements seem to flow between muscles more quickly.

Doctors cannot yet cure either condition, but they may be able to ease the symptoms with treatment.