What is the Treatment for Chorea?

There is no one standard treatment for chorea as the causes are varied. Treatment is started based on the type of chorea and the associated disease and most patients are given symptomatic treatment. The aim of treatment is to reduce morbidity and prevent complications.

• Medications: Neuroleptics are most often prescribed for symptomatic treatment of chorea. They act by blocking of dopamine receptors. The commonly prescribed neuroleptics include haloperidol, fluphenazine, risperidone, olanzapine, clozapine, and quetiapine.
• Huntington's disease: Currently there is no satisfactory treatment available for Huntington's disease. Treatment is supportive. Tetrabenazine which is a presynaptic dopamine depletory with weak D2 blocking action is approved by the Food and Drug Administration for the treatment of the signs or symptoms of Huntington's chorea. It has been found to be helpful for reducing the jerky, involuntary movements of Huntington's disease.
• Sydenham's chorea: In mild forms of the disease, bed rest during the period of active movements is usually adequate. Patients with severe disease (that is if the movements interfere with rest) need sedative drugs such as barbiturates or benzodiazepines. To prevent recurrence of rheumatic fever and Sydenham’s chorea, doctors recommend penicillin for the next 10 years.
• Drug induced chorea: Patients with this need an adjustment of medication dosage.

Patients with metabolic and endocrine-related choreas are treated based on the cause(s) of symptoms. However, for most types of choreic syndromes, causal therapies are not available and patients are given symptomatic treatment. Rarely surgery may be needed for chorea. The doctor will recommend treatment based on the signs, symptoms and the cause of chorea.

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