Chorea and hemiballismus are both forms of involuntary movement disorders. Hemiballismus can cause sudden, violent, and flinging motions. Chorea can cause irregular, spontaneous, and nonrepetitive movements.
Some health experts may describe hemiballismus as the most severe form of hyperkinetic movement disorder.
There are several types and subtypes of hyperkinetic involuntary movement disorders. Some health experts may also use the term dyskinesia to refer to these conditions, which involve unwanted movements of muscles in different areas of the body.
Both chorea and hemiballismus are types of these disorders. They can both cause sudden, unwanted movements on one side of the body. Though similar, they have some differences that set them apart.
In this article, we will review the differences between chorea and hemiballismus and explore how they differ from athetosis, another involuntary movement disorder.
Chorea and hemiballismus are similar hyperkinetic involuntary movement disorders. Both can cause:
- sudden, irregular movements
- typically only involve one side of the body
- occur due to damage to the brain
- may occur to one of several different underlying conditions
Chorea can affect several different muscles on the face, trunk, and limbs. Conversely, hemiballismus typically affects one side of the body’s arm or leg.
Both conditions occur due to damage to the areas of the brain that control movement. Additionally, overactivity of the chemical dopamine in the brain may also be responsible.
- athetosis causes slow, writhing, or twisting movements
- chorea causes abrupt, irregular, and sudden movements that can give the appearance of a dancing motion
- ballismus is the most severe form that involves violent flinging of the limbs
Often, a person can experience all three simultaneously or shortly after each other.
- infections, such as Lyme disease, rheumatic fever, syphilis, or HIV
- endocrine and metabolic problems such as hypoglycemia or hyperthyroidism
- use of drugs, including oral contraceptives, neuroleptics, levodopa, antihistamines, cocaine, amphetamine, or tricyclics
- exposure to toxins
- neurological conditions, such as stroke or migraine
- primary brain tumors or metastatic lesions on the brain
- vascular conditions, which affect the blood circulatory system
- vitamin deficiencies
In addition to the above, the following
- head trauma
- growths on the brain
- systemic lupus erythematosus, an autoimmune disease
Chorea causes involuntary movements on one side of the body and typically causes dance-like movements. Other signs and symptoms
- the tongue moving in and out of the mouth
- alternating squeezing and releasing of the fingers
- seizures and headaches in children with rheumatic fever
For example, a person who had a stroke may develop headaches or a drooping face. People with tumors on the brain may develop other neurological issues, such as an inability to follow directions.
Treatments for both conditions involve a combination of treating symptoms and the underlying condition. The severity of the underlying condition will affect a person’s overall prognosis.
Treatments for chorea
- neuroleptics, which are medications to block dopamine receptors
- other medications to block dopamine receptors
- plasmapheresis, which involves separating the plasma from blood cells, for people with rheumatic fever
- steroids for chorea that may occur following a heart transplant
- experimental surgical interventions, including deep brain stimulation and neural cell transplantation
Treatments for hemiballismus
- antidopaminergic medications
- other medications such as benzodiazepines, anti-epileptics, and tetrabenazine
- surgical interventions such as stereotactic posteroventral pallidotomy, which uses radiofrequency electrodes for treating neurological conditions
Treating the underlying condition will vary greatly according to the underlying cause of either movement disorder. A person should talk with a doctor about what treatments will work best for them.
Hemiballismus and chorea are both hyperkinetic involuntary movement disorders. Experts describe them as being similar conditions, with hemiballismus being the more severe form of chorea.
Chorea can cause dance-like movements on one side of the body that can affect the face, trunk, and limbs. In most cases, hemiballismus affects one side of the body and causes a violent jerky motion in the arm, leg, or both.
Chorea and hemiballismus have similar causes and treatment options, and doctors may also need to treat the underlying condition causing them. With treatment, a person should see some improvement in their symptoms.