choreiform

Choreiform is an adjective used in neurology to describe movement abnormalities that resemble chorea. Choreiform movements are typically rapid, irregular, non-rhythmic, and dance-like, often flowing from one region of the body to another. They are usually involuntary and may be worsened by stress or voluntary action, with some patients noting partial suppression during sleep. The term is used to indicate resemblance to chorea without necessarily fulfilling its strict diagnostic criteria.

Choreiform movements can be a primary feature of certain hereditary disorders or a secondary sign of various diseases. They may affect the face, limbs, and trunk and can be intermittent or continuous. Because they reflect dysfunction in basal ganglia circuits, choreiform movements can accompany a range of neurological and systemic conditions and may appear with other signs of hyperkinesia or hypotonia depending on the underlying cause.

Common etiologies include Huntington’s disease and other inherited choreas; Sydenham chorea and other postinfectious or autoimmune choreiform syndromes; neurodegenerative and metabolic disorders such as Wilson’s disease, non-ketotic hyperglycemia–related hemichorea, and thyrotoxicosis; vascular lesions of the basal ganglia; and drug-induced movement disorders, notably tardive dyskinesia and levodopa-induced dyskinesias. Less frequently, choreiform movements may arise from infections, sleep deprivation, or systemic illnesses.

Diagnosis relies on clinical observation and history, with targeted testing to determine etiology. Differential diagnosis includes tics, myoclonus, dystonia, athetosis, and ballistic movements. Imaging or laboratory studies help identify structural lesions, metabolic abnormalities, or autoimmune processes contributing to the abnormal movements.

Etymology: from Greek chorea meaning “dance” plus -iform meaning “in the form of.”