WordNet

the act of changing the location of something; "the movement of cargo onto the vessel"
the driving and regulating parts of a mechanism (as of a watch or clock); "it was an expensive watch with a diamond movement"
a natural event that involves a change in the position or location of something (同)motion
a group of people with a common ideology who try together to achieve certain general goals; "he was a charter member of the movement"; "politicians have to respect a mass movement"; "he led the national liberation front" (同)social movement, front
a major self-contained part of a symphony or sonata; "the second movement is slow and melodic"

PrepTutorEJDIC

〈U〉(…の)『運動』,『動き』;移動《+『of』+『名』》 / 〈C〉動作,身振り / 〈C〉《複数形で》行動,活動 / 〈C〉(…に向かう)(事熊の)成り行き,動向《+『toward』+『名』》 / 〈C〉(目標を達成するための一群の人たちの)運動 / 〈C〉(賛団の)移動,移住;(人口の)異動《+『of』+『名』》 / 〈C〉楽章 / 〈C〉(時計などの)機械装置,動く仕掛け

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2019/08/07 04:20:29」(JST)

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Chorea (or choreia, occasionally) is an abnormal involuntary movement disorder, one of a group of neurological disorders called dyskinesias. The term chorea is derived from the Ancient Greek: χορεία ("dance"; see choreia), as the quick movements of the feet or hands are comparable to dancing.

The term hemichorea refers to chorea of one side of the body, such as chorea of one arm but not both (analogous to hemiballismus).

Presentation

Chorea is characterized by brief, semi-directed, irregular movements that are not repetitive or rhythmic, but appear to flow from one muscle to the next.

These 'dance-like' movements of chorea often occur with athetosis, which adds twisting and writhing movements. Walking may become difficult, and include odd postures and leg movements.

Unlike ataxia, which affects the quality of voluntary movements, or Parkinsonism, which is a hindrance of voluntary movements, the movements of chorea and ballism occur on their own, without conscious effort. Thus, chorea is said to be a hyperkinetic movement disorder.

When chorea is serious, slight movements will become thrashing motions; this form of severe chorea is referred to as ballism or ballismus.

Causes

Huntington’s disease

Huntington's disease is a neurodegenerative disease and most common inherited cause of chorea. The condition was formerly called Huntington's chorea but was renamed because of the important non-choreic features including cognitive decline and behavioural change.^[1]

Other genetic causes

Other genetic causes of chorea are rare. They include the classical Huntington's disease 'mimic' or phenocopy syndromes, called Huntington's disease-like syndrome types 1, 2 and 3; inherited prion disease, the spinocerebellar ataxias type 1, 3 and 17, neuroacanthocytosis, dentatorubral-pallidoluysian atrophy (DRPLA), brain iron accumulation disorders, Wilson's disease, benign hereditary chorea, Friedreich's ataxia, mitochondrial disease and Rett syndrome.^[2]

Acquired causes

The most common acquired causes of chorea are cerebrovascular disease and, in the developing world, HIV infection—usually through its association with cryptococcal disease.^[2]

Sydenham's chorea occurs as a complication of streptococcal infection. Twenty percent (20%) of children and adolescents with rheumatic fever develop Sydenham's chorea as a complication. It is increasingly rare, which may be partially due to penicillin, improved social conditions, and/or a natural reduction in the bacteria ( Streptococcus ) it has stemmed from. Psychological symptoms may precede or accompany this acquired chorea and may be relapsing and remitting. The broader spectrum of paediatric autoimmune neuropsychiatric disorders associated with streptococcal infection can cause chorea and are collectively referred to as PANDAS.^[2]

Chorea gravidarum refers to choreic symptoms that occur during pregnancy. If left untreated, the disease resolves in 30% of patients before delivery but, in the other 70%, it persists. The symptoms then progressively disappear in the next few days following the delivery.^[2]

Chorea may also be caused by drugs (commonly levodopa, anti-convulsants and anti-psychotics).^[2]

Other acquired causes include systemic lupus erythematosus, antiphospholipid syndrome, thyrotoxicosis, polycythaemia rubra vera,^[2] transmissible spongiform encephalopathies and coeliac disease.^[3]

Treatment

There is no standard course of treatment for chorea. Treatment depends on the type of chorea and the associated disease. Although there are many drugs that can control it, no cure has yet been identified.

Form	Treatment
Huntington's-related	A common treatment is dopaminergic antagonists, although treatment is largely supportive. Tetrabenazine is the only FDA approved drug for the treatment of Huntington's Disease related chorea.
Sydenham's chorea	Haloperidol, carbamazepine and valproic acid. Usually involves antibiotic drugs to treat the infection, followed by drug therapy to prevent recurrence.
Chorea gravidarum	haloperidol,^[4]^[5]^[6] chlorpromazine alone or in combination with diazepam, also pimozide can also be used.
Wilson's disease	Reducing levels of copper in the body using D-penicillinamine, trientine hydrochloride, tetrathiomolybdate, and other chelating agents
Drug-induced chorea	Adjusting medication dosages.
Metabolic and endocrine-related choreas	Treated according to their causes.

History

Historically, choreas like Huntington disease and Sydenham's chorea were called Saint Vitus' dance, related to a series of social phenomena of the same name.^[7]

Notes

^ Gillian, Bates; Sarah, Tabrizi; Lesley, Jones (2014). Huntington's disease (4th ed.). Oxford University Press. ISBN 978-0199929146.
^ ^a ^b ^c ^d ^e ^f Wild, EJ; Tabrizi, SJ (November 2007). "The differential diagnosis of chorea". Practical Neurology. 7 (6): 360–73. doi:10.1136/pn.2007.134585. PMID 18024776.
^ Bushara, Khalafalla O. (2005). "Neurologic presentation of celiac disease". Gastroenterology. 128 (4 Suppl 1): S92–7. doi:10.1053/j.gastro.2005.02.018. PMID 15825133.
^ Axley, John (1972). "Rheumatic chorea controlled with haloperidol". The Journal of Pediatrics. 81 (6): 1216–7. doi:10.1016/S0022-3476(72)80272-5. PMID 4643046.
^ Patterson, John F. (1979). "Treatment of Chorea Gravidarum With Haloperidol". Southern Medical Journal. 72 (9): 1220–1. doi:10.1097/00007611-197909000-00044. PMID 472859.
^ Donaldson JO (March 1982). "Control of choreia gravidarum with haloperidol". Obstetrics and Gynecology. 59 (3): 381–2. PMID 7078886.
^ Lawrence, David M. (2009). Huntington's Disease. Infobase Publishing. ISBN 9780791095867.

External links

Chorea Gravidarum~clinical at eMedicine

UpToDate Contents

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1. 舞踏病の概要 overview of chorea
2. シデナム舞踏病 sydenham chorea
3. 小児における運動過多な運動障害 hyperkinetic movement disorders in children
4. ハンチントン病：管理 huntington disease management
5. 神経有棘赤血球症 neuroacanthocytosis

English Journal

The Devil is in the Details: Confidentiality Challenges in the Age of Genetics.

Daly BJ1, Rosko A, Zhang S, Lazarus HM.
HEC forum : an interdisciplinary journal on hospitals' ethical and legal issues.HEC Forum.2015 Mar;27(1):79-86. doi: 10.1007/s10730-014-9245-5.
This clinical case report illustrates the potential dilemmas that can arise from knowledge gained through genetic analysis. These conflicts require careful ethical analysis of presumed duties to protect patient privacy and maintain confidentiality, the duty to warn a second party of a health risk, a
PMID 25085670

Antineuronal Antibodies in a Heterogeneous Group of Youth and Young Adults with Tics and Obsessive-Compulsive Disorder.

Cox CJ1, Zuccolo AJ, Edwards EV, Mascaro-Blanco A, Alvarez K, Stoner J, Chang K, Cunningham MW.
Journal of child and adolescent psychopharmacology.J Child Adolesc Psychopharmacol.2015 Feb 6. [Epub ahead of print]
Background and objective: Antineuronal antibodies have been implicated in tic and obsessive compulsive disorders (OCD) associated with group A streptococcal infections. We investigated antineuronal autoantibody levels as well as antibody-mediated neuronal cell signaling activity, as previously repor
PMID 25658702

Therapeutic Plasma Apheresis as a Treatment for 35 Severely Ill Children and Adolescents with Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections.

Latimer ME1, L'Etoile N, Seidlitz J, Swedo SE.
Journal of child and adolescent psychopharmacology.J Child Adolesc Psychopharmacol.2015 Feb 6. [Epub ahead of print]
Background: Because of its reported similarities to Sydenham chorea, therapeutic plasma apheresis (TPA) has been proposed as a potential treatment of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS). To date, support for the use of TPA has been limite
PMID 25658452

Japanese Journal

経過中に振戦,舞踏様運動を呈した脊髄性進行性筋萎縮症の1剖検例

金藤大三,井上一彦,下田光太郎,土居充,北川達也,熊田裕子,宮田元,大浜栄作
臨床神経学 40(8), 801-806, 2000-08-01
NAID 10008310143

慢性C型肝炎に対するインターフェロン療法中に舞踏病様運動を呈した1例

吉窪誠司,木村圭志,水足謙介,加茂章二郎,前田和弘,小畑伸一郎
日本内科学会雑誌 86(6), 1036-1038, 1997-06-10
NAID 10005231094

<Case Reports>A case of chronic and progressive choreiform movemetnt disorder with evident familial History

HASHIMOTO Atsutaka,NAKAMURA Kimi,YANAI Mika,TSURUTA Chihiro,IIDA Masashi,HANADA Masanori
Acta medica Kinki University 17(2), 183-190, 1992-11-00
… A case of chronic and progressive choreiform movement disorder with evident familial history was reported. … The patient, a 68-year-old housewife, developed typical involuntary movement and psychotic symptoms concomitant with Huntington's chroea. … Choreiform movement, however, was not indicated in the son. … Thus familial history of movement disorder is significant. …
NAID 110000007319

Related Pictures

★リンクテーブル★

リンク元	「不随意運動」「舞踏様運動」「choreatic syndrome」「senile chorea」「choreatic disorder」
関連記事	「movement」「choreiform」

「不随意運動」

Classification	D ICD-10: G25.5; ICD-9-CM: 333.5; MeSH: D002819; DiseasesDB: 16662;
External resources	eMedicine: neuro/62; Patient UK: Chorea;

Chorea
Specialty	Neurology

　　[★]

英: involuntary movement IVM
関: 不随意筋