Choreiform gait

What it is

A choreiform gait is the walk of a patient with chorea. Chorea is involuntary, sudden, irregular, nonrepetitive, arrhythmic movements of the limbs, neck, head, and/or face. Athetosis, involuntary writhing movements particularly of the hands and fingers, belongs beside it.

Causes and risk

The gait page names two: Huntington disease, and Sydenham chorea in rheumatic heart disease.

Huntington disease is a neurodegenerative movement disorder, autosomal-dominant, caused by an increased number of CAG trinucleotide repeats in the huntingtin gene, which eventually leads to the dysfunction of subcortical motor circuits. The disease runs in two phases: 1) the early stages, where chorea characterizes the picture; 2) the advanced stages, where hypokinetic and akinetic symptoms may dominate and dementia, depression and behavioral disorders are common.

Sydenham's chorea is one of the major criteria of rheumatic fever, the S of JONES, and those major criteria are counted: first, J for joints, that is migratory polyarthritis; second, carditis, that is pancarditis with endocarditis, myocarditis and pericarditis; third, N for nodules, subcutaneous, painless and firm; fourth, E for erythema marginatum, a painless ring-shaped rash; fifth, S for Sydenham's chorea, involuntary movements with emotional lability. It is the last manifestation of rheumatic fever.