Chorea and hemiballismus are both forms of involuntary movement disorders. 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.

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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

Experts describe hemiballismus as the most severe form on the chorea spectrum. Others describe chorea as dance-like movements that are irregular, nonrepetitive, and spontaneous. Experts usually refer to hemiballismus as producing sudden, violent, and flinging motions.

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.

Some experts describe athetosis, chorea, and hemiballismus as three involuntary movement disorders with different severity levels that appear on a spectrum. Some health experts break down symptom severity as follows:

  • 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.

A leading cause of chorea and hemiballismus is Huntington’s disease, a genetic disorder. Other possible causes of the conditions may include:

In addition to the above, the following may cause hemiballismus:

  • 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 can include:

  • the tongue moving in and out of the mouth
  • alternating squeezing and releasing of the fingers
  • seizures and headaches in children with rheumatic fever

Hemiballismus can cause jerky, violent movements in one leg, arm, or both on the same side. Other symptoms relating to hemiballismus can vary according to the underlying cause.

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 may involve:

  • 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 may include:

  • 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.