Differential Diagnosis of Movement Disorders

Chorea, Athetosis, and Ballism: Etiologies and Differentiation

Movement disorders encompass a variety of neurological conditions characterized by abnormal involuntary movements. Among these, chorea, athetosis, and ballism present distinct patterns requiring careful clinical differentiation.

Understanding Chorea

Chorea consists of irregular, involuntary movements that appear dance-like or flowing. Common causes include Huntington’s disease, Sydenham’s chorea, and metabolic disorders.

Athetosis: Slow and Writhing Movements

Athetosis is characterized by slow, twisting, and writhing movements, often affecting distal extremities. It is typically associated with cerebral palsy and basal ganglia dysfunction.

Ballism: Violent Flailing Movements

Ballism refers to large-amplitude, forceful flinging of limbs, usually unilateral. The most common cause is a lesion in the subthalamic nucleus, as seen in hemiballismus.

Diagnostic Approach

• Detailed patient history and neurological examination.
• Neuroimaging (MRI/CT) to identify lesions or structural abnormalities.
• Genetic and metabolic testing when applicable.

Treatment Strategies

Management of movement disorders depends on the underlying cause:

• Medications such as tetrabenazine for chorea.
• Physical therapy for improving motor control.
• Surgical interventions in refractory cases (e.g., deep brain stimulation).