Pediatric chorea is a movement disorder that causes uncontrolled twitches or large muscle spasms.
Chorea is a condition that causes involuntary muscle actions, which can be small or severe. The movements are often described as “dance-like,” as they appear to move across the body from one muscle group to the next. They typically do not follow a pattern, and the twitches can take place on only one side of the body (hemichorea). A child’s facial movements, posture, speech, swallowing and walking may also be affected.
Chorea is part of a larger group of neurological disorders that impact the nervous system called dyskinesia. Similar conditions include ataxia, dystonia, myoclonus, Parkinson’s disease and Tourette syndrome. Children are typically diagnosed at age 3 and older.
Chorea can occur at any age and be due to several possible triggers, which include:
- Brain tumors and lymphoma
- Cerebral palsy
- Exposure to toxins (carbon monoxide, manganese or pesticides)
- Head trauma
- Hyperthyroidism or hypothyroidism
- Infections like chicken pox, Lyme disease, HIV-related immune deficiencies and bacterial endocarditis (heart infection)
- Inherited conditions, including Huntington’s (progressive breakdown of nerve cells in the brain) or Wilson’s disease (causes too much copper to gather in the organs)
- Kidney failure
- Metabolic disorders, including blood sugar, calcium, magnesium, sodium levels and vitamin B-12 deficiency in children 3 years or younger
- Reaction to medicines called antimetabolites (drugs that interfere with), including anticonvulsants (for seizures), antihistamines (for allergies), ADHD (attention deficit hyperactivity disorder) medicines and psychiatric/mood disorder medicines
- Rheumatic fever (result of strep throat or scarlet fever)
- Vascular issues that involve abnormal connections between the arteries and veins in the brain or spine, due to hemorrhages or strokes
Symptoms of chorea include uncontrolled movements that can take place anywhere on the body. The location will be dependent on the amount of damage to the nervous system.
- Arm, head or leg jerks
- Difficulty walking, falling or tripping
- Drooling or spitting
- Facial tics like winking, rapid eye blinking, nose scrunching or pulling up/down/sideways on the mouth
- Grunting, slurred speech and involuntary sounds
- Large muscle spasms
- Milkmaid’s grip (squeezing and releasing hands, as if milking)
- Swelling, pain and warmth around the joints (rheumatic fever)
- Teeth grinding or tongue biting
- Unable to sit or stand still