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Chorea in Adults Treatment & Management

  • Author: Stephanie M Vertrees, MD; Chief Editor: Selim R Benbadis, MD  more...
 
Updated: Oct 24, 2014
 

Medical Care

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  • Only symptomatic treatment is available for patients with chorea. Chorea may be a disabling symptom, leading to bruises, fractures, and falls, and may impair the ability of patients to feed themselves. In addition, patients sometimes express a desire for antichorea treatment for cosmetic reasons.
  • The most widely used agents in the treatment of chorea are the neuroleptics. The basis of their mechanism of action is thought to be related to blocking of dopamine receptors. Neuroleptics can be classified as typical and atypical. Typical neuroleptics include haloperidol and fluphenazine. Atypical neuroleptics include risperidone, olanzapine, clozapine, and quetiapine.
  • Dopamine-depleting agents, such as reserpine and tetrabenazine, represent another option in the treatment of chorea.[13, 14]
  • GABAergic drugs, such as clonazepam, gabapentin, and valproate[89] , can be used as adjunctive therapy.
  • Coenzyme Q10 alone and in combination with minocycline have been proposed as potential therapies and have shown promise in HD rodent models. Coenzyme Q10 is thought to target mitochondrial dysfunction, which has been implicated as one of the pathologic mechanisms of mutant huntingtin. Minocycline, one of the tetracyclines, is known to have anti-apoptosis effects.[10, 11]
  • Intravenous immunoglobulin and plasmapheresis may shorten the course of the illness and decrease symptom severity in patients with Sydenham chorea.
  • Chorea following cardiac transplantation has been reported to be responsive to steroid treatment.[64]
  • Reports of drug treatment for hemiballism must take into account the high spontaneous remission rate for the disorder. Anecdotal reports must be viewed with caution, unless they can demonstrate that the response is due to the agent (by recurrence of the movements with drug withdrawal). The rarity of this disorder and the severity of its manifestations have precluded placebo-controlled drug trials. Pharmacologic treatment is the same as that prescribed for other choreatic disorders.[22, 24, 90, 8]
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Surgical Care

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  • Deep brain stimulation is an emerging technique that may benefit patients, at least in certain cases.
    • In 2000, Thompson et al reported a reduction in choreiform movements in 2 pediatric cases of chorea. One patient had cerebral palsy from birth secondary to brain hemorrhage. The other, an 11-year-old child, developed chorea subsequent to a thalamic hemorrhage 4 years before. Both children improved after the procedure.[91]
    • Reported in 2003, Krauss et al tested globus pallidus stimulation on 2 patients with dystonia (one adult and one child) and 4 adult patients with essentially static (ie, nonchanging) chorea secondary to cerebral palsy. The dystonia patients markedly improved. Two of the 4 chorea patients showed no improvement, but 2 showed mild improvement.[92]
    • In 2004, Moro et al reported on bilateral globus pallidus internus stimulation on a patient with Huntington disease (HD). Stimulation at 130 and 40 Hz improved the chorea, but the stimulation at 130 Hz worsened the bradykinesia. Stimulation of 40 Hz had little effect on the bradykinesia and appeared to increase blood flow (assessed by positron emission tomography scanning) in areas associated with executive functions and judgment.[93]
  • Although deep brain stimulation is not yet used routinely for chorea, as it is for PD, exciting progress has been made with this modality.
  • Cell transplantation is controversial and in early stages of research. It has shown variable results for HD patient participants.
    • In 2006, Bachoud-L é vi et al reported that fetal neural cell transplantation into host striatum resulted in stabilization or improvement in chorea, oculomotor dysfunction, gait, tapping, and cognition, but dystonia progressed at the same rate as nongrafted patients. However, these results persisted for up to 6 years only, and then patients' disease continued to progress at pretransplantation rates.[94]
    • In 2008, Keene et al demonstrated on autopsy that fetal neural cell grafts in 2 patients had shown neuronal differentiation and survival, but they had poor integration with host striatum, likely explaining the lack of clinical improvement in these patients.[95]
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Contributor Information and Disclosures
Author

Stephanie M Vertrees, MD Fellow in Public Health, Weill Cornell Medical College-Hospital for Special Surgery Fellowship in Medical Ethics; Fellow in Neuromuscular Medicine, Hospital for Special Surgery

Stephanie M Vertrees, MD is a member of the following medical societies: American Academy of Neurology, American Medical Womens Association

Disclosure: Nothing to disclose.

Coauthor(s)

Stephen A Berman, MD, PhD, MBA Professor of Neurology, University of Central Florida College of Medicine

Stephen A Berman, MD, PhD, MBA is a member of the following medical societies: Alpha Omega Alpha, American Academy of Neurology, Phi Beta Kappa

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

Selim R Benbadis, MD Professor, Director of Comprehensive Epilepsy Program, Departments of Neurology and Neurosurgery, Tampa General Hospital, University of South Florida College of Medicine

Selim R Benbadis, MD is a member of the following medical societies: American Academy of Neurology, American Medical Association, American Academy of Sleep Medicine, American Clinical Neurophysiology Society, American Epilepsy Society

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Cyberonics; Eisai; Lundbeck; Sunovion; UCB; Upsher-Smith<br/>Serve(d) as a speaker or a member of a speakers bureau for: Cyberonics; Eisai; Glaxo Smith Kline; Lundbeck; Sunovion; UCB<br/>Received research grant from: Cyberonics; Lundbeck; Sepracor; Sunovion; UCB; Upsher-Smith.

Additional Contributors

Stephen T Gancher, MD Adjunct Associate Professor, Department of Neurology, Oregon Health Sciences University

Stephen T Gancher, MD is a member of the following medical societies: American Academy of Neurology, American Neurological Association, International Parkinson and Movement Disorder Society

Disclosure: Nothing to disclose.

Acknowledgements

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous authors Eric Dinnerstein, MD, Maria Alejandra Herrera, MD, and Nestor Galvez-Jimenez, MD, MSc, MHA, to the development and writing of this article.

References
  1. Berman SA. Chorea. Joseph AB, Young RR, eds. Movement Disorders in Neurology and Neuropsychiatry. 2nd ed. Malden, Mass: Blackwell Science; 1999. 481-94.

  2. Dorland WA, ed. Dorlands Illustrated Medical Dictionary. 30th ed. Philadelphia, Pa: WB Saunders; 2003.

  3. Barbeau A, Duvoisin RC, Gerstenbrand F, Lakke JP, Marsden CD, Stern G. Classification of extrapyramidal disorders. Proposal for an international classification and glossary of terms. J Neurol Sci. 1981 Aug. 51(2):311-27. [Medline].

  4. Dewey RB Jr, Jankovic J. Hemiballism-hemichorea. Clinical and pharmacologic findings in 21 patients. Arch Neurol. 1989 Aug. 46(8):862-7. [Medline].

  5. Fukui T, Hasegawa Y, Seriyama S, et al. Hemiballism-hemichorea induced by subcortical ischemia. Can J Neurol Sci. 1993 Nov. 20(4):324-8. [Medline].

  6. Glass JP, Jankovic J, Borit A. Hemiballism and metastatic brain tumor. Neurology. 1984 Feb. 34(2):204-7. [Medline].

  7. Sanchez-Ramos JR, Factor SA, Weiner WJ, Marquez J. Hemichorea-hemiballismus associated with acquired immune deficiency syndrome and cerebral toxoplasmosis. Mov Disord. 1989. 4(3):266-73. [Medline].

  8. Vidakovic A, Dragasevic N, Kostic VS. Hemiballism: report of 25 cases. J Neurol Neurosurg Psychiatry. 1994 Aug. 57(8):945-9. [Medline].

  9. Chen-Plotkin AS, Sadri-Vakili G, Yohrling GJ, Braveman MW, Benn CL, Glajch KE, et al. Decreased association of the transcription factor Sp1 with genes downregulated in Huntingtons disease. Neurobiol Dis. 2006 May. 22(2):233-41. [Medline].

  10. Smith KM, Matson S, Matson WR, Cormier K, Del Signore SJ, Hagerty SW. Dose ranging and efficacy study of high-dose coenzyme Q10 formulations in Huntingtons disease mice. Biochim Biophys Acta. 2006 Jun. 1762(6):616-26. [Medline].

  11. Stack EC, Smith KM, Ryu H, Cormier K, Chen M, Hagerty SW, et al. Combination therapy using minocycline and coenzyme Q10 in R6/2 transgenic Huntingtons disease mice. Biochim Biophys Acta. 2006 Mar. 1762(3):373-80. [Medline].

  12. Zuccato C, Belyaev N, Conforti P, Ooi L, Tartari M, Papadimou E, et al. Widespread disruption of repressor element-1 silencing transcription factor/neuron-restrictive silencer factor occupancy at its target genes in Huntingtons disease. J Neurosci. 2007 Jun 27. 27(26):6972-83. [Medline].

  13. Leavitt BR, Hayden MR. Is tetrabenazine safe and effective for suppressing chorea in Huntingtons disease?. Nat Clin Pract Neurol. 2006 Oct. 2(10):536-7. [Medline].

  14. Savani AA, Login IS. Tetrabenazine as antichorea therapy in Huntington disease: a randomized controlled trial. Neurology. 2007 Mar 6. 68(10):797; author reply 797. [Medline].

  15. Gomez-Anson B, Alegret M, Munoz E, Sainz A, Monte GC, Tolosa E. Decreased frontal choline and neuropsychological performance in preclinical Huntington disease. Neurology. 2007 Mar 20. 68(12):906-10. [Medline].

  16. Glass M, Dragunow M, Faull RL. The pattern of neurodegeneration in Huntingtons disease: a comparative study of cannabinoid, dopamine, adenosine and GABA(A) receptor alterations in the human basal ganglia in Huntingtons disease. Neuroscience. 2000. 97(3):505-19. [Medline].

  17. Saft C, Lauter T, Kraus PH, Przuntek H, Andrich JE. Dose-dependent improvement of myoclonic hyperkinesia due to Valproic acid in eight Huntingtons Disease patients: a case series. BMC Neurol. 2006 Feb 28. 6:11. [Medline].

  18. Curtis MA, Faull RL, Glass M. A novel population of progenitor cells expressing cannabinoid receptors in the subependymal layer of the adult normal and Huntingtons disease human brain. J Chem Neuroanat. 2006 Apr. 31(3):210-5. [Medline].

  19. de Lago E, Fernandez-Ruiz J, Ortega-Gutierrez S, Cabranes A, Pryce G, Baker D, et al. UCM707, an inhibitor of the anandamide uptake, behaves as a symptom control agent in models of Huntingtons disease and multiple sclerosis, but fails to delay/arrest the progression of different motor-related disorders. Eur Neuropsychopharmacol. 2006 Jan. 16(1):7-18. [Medline].

  20. Dubinsky RM, Greenberg M, Di Chiro G, et al. Hemiballismus: study of a case using positron emission tomography with 18fluoro-2-deoxyglucose. Mov Disord. 1989. 4(4):310-9. [Medline].

  21. Klawans HL. Chorea. Can J Neurol Sci. 1987 Aug. 14(3 Suppl):536-40. [Medline].

  22. Evidente VG, Gwinn-Hardy K, Caviness JN, Alder CH. Risperidone is effective in severe hemichorea/hemiballismus. Mov Disord. 1999 Mar. 14(2):377-9. [Medline].

  23. Inzelberg R, Korczyn AD. Persistent hemiballism in Parkinsons disease. J Neurol Neurosurg Psychiatry. 1994 Aug. 57(8):1013-4. [Medline].

  24. Johnson WG, Fahn S. Treatment of vascular hemiballism and hemichorea. Neurology. 1977 Jul. 27(7):634-6. [Medline].

  25. Martinez-Martin P. Hemichorea-hemiballism in AIDS. Mov Disord. 1990. 5(2):180. [Medline].

  26. Riley D, Lang AE. Hemiballism in multiple sclerosis. Mov Disord. 1988. 3(1):88-94. [Medline].

  27. Jankovic J. Huntingtons disease, Wilsons disease, and neuroacanthocytosis. A Comprehensive Review of Movement Disorders for the Clinical Practitioner. 2nd Annual Course. New York, NY: Columbia University; 1992. 261-78.

  28. Petrukhin K, Lutsenko S, Chernov I, et al. Characterization of the Wilson disease gene encoding a P-type copper transporting ATPase: genomic organization, alternative splicing, and structure/function predictions. Hum Mol Genet. 1994 Sep. 3(9):1647-56. [Medline].

  29. Bird TD, Carlson CB, Hall JG. Familial essential (benign) chorea. J Med Genet. 1976 Oct. 13(5):357-62. [Medline].

  30. Breedveld GJ, van Dongen JW, Danesino C, et al. Mutations in TITF-1 are associated with benign hereditary chorea. Hum Mol Genet. 2002 Apr 15. 11(8):971-9. [Medline].

  31. Burns J, Neuhauser G, Tomasi L. Benign hereditary non-progressive chorea of early onset. Clinical genetics of the syndrome and report of a new family. Neuropadiatrie. 1976 Nov. 7(4):431-8. [Medline].

  32. Chun RW, Daly RF, Mansheim BJ Jr, Wolcott GJ. Benign familial chorea with onset in childhood. JAMA. 1973 Sep 24. 225(13):1603-7. [Medline].

  33. Damasio H, Antunes L, Damasio AR. Familial nonprogressive involuntary movements of childhood. Ann Neurol. 1977 Jun. 1(6):602-3. [Medline].

  34. Haerer AF, Currier RD, Jackson JF. Hereditary nonprogressive chorea of early onset. N Engl J Med. 1967 Jun 1. 276(22):1220-4. [Medline].

  35. Kuwert T, Lange HW, Langen KJ, et al. Normal striatal glucose consumption in two patients with benign hereditary chorea as measured by positron emission tomography. J Neurol. 1990 Apr. 237(2):80-4. [Medline].

  36. MacMillan JC, Morrison PJ, Nevin NC, Shaw DJ, Harper PS, Quarrell OW, et al. Identification of an expanded CAG repeat in the Huntington's disease gene (IT15) in a family reported to have benign hereditary chorea. J Med Genet. 1993 Dec. 30(12):1012-3. [Medline].

  37. Rice E, Terrence C. Computerized tomography in hereditary nonprogressive chorea. Arch Neurol. 1979 Apr. 36(4):249-50. [Medline].

  38. Robinson RO, Thornett CE. Benign hereditary chorea--response to steroids. Dev Med Child Neurol. 1985 Dec. 27(6):814-6. [Medline].

  39. Suchowersky O, Hayden MR, Martin WR, et al. Cerebral metabolism of glucose in benign hereditary chorea. Mov Disord. 1986. 1(1):33-44. [Medline].

  40. Wheeler PG, Weaver DD, Dobyns WB. Benign hereditary chorea. Pediatr Neurol. 1993 Sep-Oct. 9(5):337-40. [Medline].

  41. Yapijakis C, Kapaki E, Zournas C, Rentzos M, Loukopoulos D, Papageorgiou C. Exclusion mapping of the benign hereditary chorea gene from the Huntingtons disease locus: report of a family. Clin Genet. 1995 Mar. 47(3):133-8. [Medline].

  42. McKusick V. Huntington disease; HD. OMIM ID #143100. Online Mendelian Inheritance in Man. Available at http://www.ncbi.nlm.nih.gov/omim/143100. Accessed: March 17, 2009.

  43. McKusick V. Choreoacanthocytosis; CHAC. OMIM ID #200150. Online Mendelian Inheritance in Man. Available at http://www.ncbi.nlm.nih.gov/omim/200150. Accessed: March 17, 2009.

  44. McKusick V. Chorea, benign hereditary; BHC. OMIM ID #118700. Online Mendelian Inheritance in Man. Available at http://www.ncbi.nlm.nih.gov/omim/118700. Accessed: March 17, 2009.

  45. Jones R, Stout JC, Labuschagne I, Say M, Justo D, Coleman A, et al. The potential of composite cognitive scores for tracking progression in Huntington's disease. J Huntingtons Dis. 2014. 3(2):197-207. [Medline].

  46. Klein C. The Wilson films--Huntington's chorea. Mov Disord. 2011 Dec. 26(14):2464-6. [Medline].

  47. Kobal J, Dobson-Stone C, Danek A, Fidler V, Zvan B, Zaletel M. Chorea-acanthocytosis presenting as dystonia. Acta Clin Croat. 2014 Mar. 53(1):107-12. [Medline].

  48. Alcock, NS. A note of the pathology of senile chorea (non-hereditary). Brain. 1936. 59:376-87.

  49. Friedman JH, Ambler M. A case of senile chorea. Mov Disord. 1990. 5(3):251-3. [Medline].

  50. Galvez-Jimenez N, Friedman J, Lang A. A consistent MRI pattern in three cases of senile chorea. Neurology. 1995. 45 (Supplement 4):A185.

  51. Giedd JN, Rapoport JL, Kruesi MJ, Parker C, Schapiro MB, Allen AJ, et al. Sydenhams chorea: magnetic resonance imaging of the basal ganglia. Neurology. 1995 Dec. 45(12):2199-202. [Medline].

  52. Swedo SE. Sydenhams chorea. A model for childhood autoimmune neuropsychiatric disorders. JAMA. 1994 Dec 14. 272(22):1788-91. [Medline].

  53. Beato R, Maia DP, Teixeira AL Jr, Cardoso F. Executive functioning in adult patients with Sydenham's chorea. Mov Disord. 2010 May 15. 25(7):853-7. [Medline].

  54. Gusella JF, MacDonald ME. Huntingtons disease: seeing the pathogenic process through a genetic lens. Trends Biochem Sci. July 2006. 31(pt 9):533-40.

  55. Nutting PA, Cole BR, Schimke RN. Benign, recessively inherited choreo-athetosis of early onset. J Med Genet. 1969 Dec. 6(4):408-10. [Medline].

  56. Fisher M, Sargent J, Drachman D. Familial inverted choreoathetosis. Neurology. 1979 Dec. 29(12):1627-31. [Medline].

  57. Wheeler PG, Dobyns WB, Plager DA, Ellis FD. Familial remitting chorea, nystagmus, and cataracts. Am J Med Genet. 1993 Dec 1. 47(8):1215-7. [Medline].

  58. Evans BK, Jankovic J. Tuberous sclerosis and chorea. Ann Neurol. 1983 Jan. 13(1):106-7. [Medline].

  59. Ross CA, Margolis RL, Rosenblatt A, et al. Huntington disease and the related disorder, dentatorubral-pallidoluysian atrophy (DRPLA). Medicine (Baltimore). 1997 Sep. 76(5):305-38. [Medline].

  60. Sethi KD, Ray R, Roesel RA, et al. Adult-onset chorea and dementia with propionic acidemia. Neurology. 1989 Oct. 39(10):1343-5. [Medline].

  61. Hefter H, Mayer P, Benecke R. Persistent chorea after recurrent hypoglycemia. A case report. Eur Neurol. 1993. 33(3):244-7. [Medline].

  62. Linazasoro G, Urtasun M, Poza JJ, et al. Generalized chorea induced by nonketotic hyperglycemia. Mov Disord. 1993. 8(1):119-20. [Medline].

  63. Toghill PJ, Johnston AW, Smith JF. Choreoathetosis in porto-systemic encephalopathy. J Neurol Neurosurg Psychiatry. 1967 Aug. 30(4):358-63. [Medline].

  64. Blunt SB, Brooks DJ, Kennard C. Steroid-responsive chorea in childhood following cardiac transplantation. Mov Disord. 1994 Jan. 9(1):112-4. [Medline].

  65. Curless RG, Katz DA, Perryman RA, et al. Choreoathetosis after surgery for congenital heart disease. J Pediatr. 1994 May. 124(5 Pt 1):737-9. [Medline].

  66. Peters AC, Vielvoye GJ, Versteeg J, et al. ECHO 25 focal encephalitis and subacute hemichorea. Neurology. 1979 May. 29(5):676-81. [Medline].

  67. Sweeney BJ, Edgecombe J, Churchill DR, et al. Choreoathetosis/ballismus associated with pentamidine-induced hypoglycemia in a patient with the acquired immunodeficiency syndrome. Arch Neurol. 1994 Jul. 51(7):723-5. [Medline].

  68. Davous P, Rondot P, Marion MH, Gueguen B. Severe chorea after acute carbon monoxide poisoning. J Neurol Neurosurg Psychiatry. 1986 Feb. 49(2):206-8. [Medline].

  69. Schwartz A, Hennerici M, Wegener OH. Delayed choreoathetosis following acute carbon monoxide poisoning. Neurology. 1985 Jan. 35(1):98-9. [Medline].

  70. Abbruzzese G, Brusa G, DallAgata D, Morena M, Spadavecchia L, Favale E. Electrophysiological analysis of motor control in patients with vascular hemichorea. Ital J Neurol Sci. 1987 Aug. 8(4):357-62. [Medline].

  71. Jones HR Jr, Baker RA, Kott HS. Hypertensive putaminal hemorrhage presenting with hemichorea. Stroke. 1985 Jan-Feb. 16(1):130-1. [Medline].

  72. Margolin DI, Marsden CD. Episodic dyskinesias and transient cerebral ischemia. Neurology. 1982 Dec. 32(12):1379-80. [Medline].

  73. Tabaton M, Mancardi G, Loeb C. Generalized chorea due to bilateral small, deep cerebral infarcts. Neurology. 1985 Apr. 35(4):588-9. [Medline].

  74. Bae SH, Vates TS Jr, Kenton EJ 3d. Generalized chorea associated with chronic subdural hematomas. Ann Neurol. 1980 Oct. 8(4):449-50. [Medline].

  75. Pavlakis SG, Schneider S, Black K, Gould RJ. Steroid-responsive chorea in moyamoya disease. Mov Disord. 1991. 6(4):347-9. [Medline].

  76. Bruyn GW, Ferrari MD. Chorea and migraine: Hemicrania choreatica?. Cephalalgia. 1984 Jun. 4(2):119-24. [Medline].

  77. Kok J, Bosseray A, Brion JP, et al. Chorea in a child with Churg-Strauss syndrome. Stroke. 1993 Aug. 24(8):1263-4. [Medline].

  78. Kimura N, Sugihara R, Kimura A, Kumamoto T, Tsuda T. [A case of neuro-Behcets disease presenting with chorea]. Rinsho Shinkeigaku. 2001 Jan. 41(1):45-9. [Medline].

  79. Caviness VS Jr. Huntingtons disease. Dev Med Child Neurol. 1985 Dec. 27(6):826-9. [Medline].

  80. Cervera R, Asherson RA, Font J, et al. Chorea in the antiphospholipid syndrome. Clinical, radiologic, and immunologic characteristics of 50 patients from our clinics and the recent literature. Medicine (Baltimore). 1997 May. 76(3):203-12. [Medline].

  81. Walker FO, Hunt VP. Ballism: an association with ventriculoperitoneal shunting. Neurology. 1990 Jun. 40(6):1004. [Medline].

  82. Rosenblatt A, Liang KY, Zhou H, Abbott MH, Gourley LM, Margolis RL. The association of CAG repeat length with clinical progression in Huntington disease. Neurology. 2006 Apr 11. 66(7):1016-20. [Medline].

  83. Burton PD. Magnetic resonance imaging and brain iron: implications in the diagnosis and pathochemistry of movement disorders and dementia. Barrow Neurological Institute Quarterly. 1987. 3, No. 4:15-29.

  84. Rutledge JN, Hilal SK, Silver AJ, et al. Study of movement disorders and brain iron by MR. Am J Neuroradiol. 1987. 8:397-411.

  85. Montoya A, Price BH, Menear M, Lepage M. Brain imaging and cognitive dysfunctions in Huntingtons disease. J Psychiatry Neurosci. 2006 Jan. 31(1):21-9. [Medline].

  86. Hosokawa S, Ichiya Y, Kuwabara Y, et al. Positron emission tomography in cases of chorea with different underlying diseases. J Neurol Neurosurg Psychiatry. 1987 Oct. 50(10):1284-7. [Medline].

  87. Otsuka M, Ichiya Y, Kuwabara Y, et al. Cerebral glucose metabolism and striatal 18F-dopa uptake by PET in cases of chorea with or without dementia. J Neurol Sci. 1993 Apr. 115(2):153-7. [Medline].

  88. Tanaka M, Hirai S, Kondo S, et al. Cerebral hypoperfusion and hypometabolism with altered striatal signal intensity in chorea-acanthocytosis: a combined PET and MRI study. Mov Disord. 1998 Jan. 13(1):100-7. [Medline].

  89. Grove VE Jr, Quintanilla J, DeVaney GT. Improvement of Huntingtons disease with olanzapine and valproate. N Engl J Med. 2000 Sep 28. 343(13):973-4. [Medline].

  90. Shannon KM. Hemiballismus. Clin Neuropharmacol. 1990 Oct. 13(5):413-25. [Medline].

  91. Thompson TP, Kondziolka D, Albright AL. Thalamic stimulation for choreiform movement disorders in children. Report of two cases. J Neurosurg. 2000 Apr. 92(4):718-21. [Medline].

  92. Krauss JK, Loher TJ, Weigel R, et al. Chronic stimulation of the globus pallidus internus for treatment of non-dYT1 generalized dystonia and choreoathetosis: 2-year follow up. J Neurosurg. 2003 Apr. 98(4):785-92. [Medline].

  93. Moro E, Lang AE, Strafella AP, et al. Bilateral globus pallidus stimulation for Huntingtons disease. Ann Neurol. 2004 Aug. 56(2):290-4. [Medline].

  94. Bachoud-Levi AC, Gaura V, Brugieres P, Lefaucheur JP, Boisse MF, Maison P, et al. Effect of fetal neural transplants in patients with Huntingtons disease 6 years after surgery: a long-term follow-up study. Lancet Neurol. 2006 Apr. 5(4):303-9. [Medline].

  95. Keene CD, Sonnen JA, Swanson PD, Kopyov O, Leverenz JB, Bird TD, et al. Neural transplantation in Huntington disease: long-term grafts in two patients. Neurology. 2007 Jun 12. 68(24):2093-8. [Medline].

  96. Souza Ad, Moloi MW. Involuntary movements due to vitamin B12 deficiency. Neurol Res. 2014 Dec. 36(12):1121-8. [Medline].

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