Coreia Diagnosis and Treatment

Clinical Characteristics

The American Heart Association notes that coreia is characterized by irregular, rapid, and non-stereotyped movements that flow randomly, giving an appearance of "dance" or dancing movements during gait, which can be associated with weakness and emotional lability 1, 2
The American Academy of Neurology and the American Heart Association describe atetosis as slower and more twisted movements, distinguishing it from coreia 1, 2

The American College of Radiology recommends that brain MRI without contrast is the optimal imaging modality for patients with coreia to identify structural causes 3
Genetic testing is recommended for suspected Huntington's disease to detect CAG repeat expansions in the huntingtin gene 3

The American Academy of Neurology differentiates tics from coreia, describing tics as very brief movements, typically shorter in duration than paroxysmal kinesigenic dyskinesia attacks 4
The American Heart Association distinguishes hipercinesia and reacción de conversión and psychogenic movement disorders from coreia 1, 2
The American Academy of Neurology and the American Heart Association note that hiperekplexia is characterized by an excessive startle response to sudden and innocuous stimuli 4

The American Academy of Child and Adolescent Psychiatry notes that patients with coreia should be evaluated periodically to detect the development of tardive dyskinesia, especially those receiving long-term neuroleptic treatment 5

Clinicians evaluating a child or adolescent with suspected Sydenham’s chorea should exclude metabolic disorders—including hyperthyroidism, hypoparathyroidism, hypoglycemia, and kernicterus—to rule out alternative causes of involuntary movements. Evidence level: not specified. 6

Recurrence of Sydenham’s chorea is reported in about 2 %–5 % of patients, with higher risk when subsequent group A streptococcal infections occur and secondary antibiotic prophylaxis is inadequate. Evidence level: not specified. 7