Chorea in children: etiology, diagnostic approach and management

Area of Science:

• Neurology
• Pediatrics
• Genetics

Background:

• Chorea involves abnormal, involuntary movements with various causes including autoimmune, hereditary, and drug-induced factors.
• While Huntington disease is common in adults, it's rare in children, where Sydenham chorea was historically prevalent but is now decreasing.
• Pediatric chorea necessitates considering diverse etiologies beyond Sydenham chorea.

Purpose of the Study:

• To review the primary causes of chorea in children.
• To outline diagnostic methods for pediatric chorea.
• To discuss management strategies for chorea in pediatric populations.

Main Methods:

• Literature review of pediatric chorea etiologies.
• Analysis of diagnostic criteria for chorea in children.
• Synthesis of current management guidelines for pediatric chorea.

Main Results:

• Common causes of childhood chorea include dyskinetic cerebral palsy, anti-NMDAR receptor encephalitis, and autoimmune conditions.
• Genetic mutations in genes like NKX2-1, ADCY-5, and SLC2A1 are increasingly recognized causes.
• Accurate diagnosis relies on a comprehensive evaluation, including neurological examination, imaging, and genetic testing.

Conclusions:

• Pediatric chorea presents a diagnostic challenge due to its varied causes.
• Early and accurate diagnosis is crucial for effective management and improved outcomes.
• This review provides a framework for understanding and managing chorea in children.