An Update on the Treatment of Chorea

  • Erin FeinsteinEmail author
  • Ruth Walker
Movement Disorders (A Videnovich, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Movement Disorders


Purpose of review

There are many causes for chorea, including genetic, autoimmune, pharmacological, and structural lesions. Where appropriate, treatment is based on reversing the underlying cause of chorea; many cases are self-limited, resolving when the primary disorder is treated. This review focuses on the management of chorea due to untreatable causes.

Recent findings

There are a limited number of double-blind randomized control trials assessing the efficacy of specific chorea treatments. Most therapeutic recommendations are based on small open-label studies, case reports, and expert opinion. This is in part due to the heterogeneity of chorea and chorea-associated syndromes and the variety of neurodegenerative phenotypes with variable progression rates.


Chorea can be treated with a variety of medications ranging from antiepileptics to antipsychotics. The recent development of selective vesicular monoamine transporter blocking agents has allowed for targeted chorea management with minimal side effects. Neurosurgical interventions such as deep brain surgery (DBS) and pallidotomy are reserved for medication-refractory chorea. As a symptom of neurodegenerative disease, chorea is only one aspect of the basal ganglia syndromes, and often, a multidisciplinary approach tailored to individual patient needs provides the best management.


Chorea Deutetrabenazine Valbenazine Deep brain stimulation 


Compliance with Ethical Standards

Conflict of Interest

Erin Feinstein declares no conflict of interest. Ruth Walker has received consulting fees from the manufacturers of valbenazine, Neurocrine Biosciences, Inc. She has also received honoraria from Advance Medical Opinion, the International Parkinson Disease and Movement Disorders Society, and GE Healthcare.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of NeurologyRutgers New Jersey Medical SchoolNewarkUSA
  2. 2.Veterans Affairs Medical Center, Department of NeurologyBronx Mount Sinai School of MedicineNew YorkUSA

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