Chorea as a manifestation of SLE is very infrequent (1% of all cases of SLE). Chorea has many underlying causes and Lupus is included in those diseases that can cause Chorea. Some of the other medical illnesses that can cause chorea include anti-cardiolipin antibody syndrome, polycythemia rubra vera, stroke, thyroid disease, and disorders of calcium, glucose or sodium metabolism. Chorea gravidarum affects females about twice as often as males. The condition usually appears after a streptococcal infection, with subsequent rheumatic fever. It may cause valvular disturbances. It is characterised by involuntary purposeless contractions of the muscles of the trunk and extremities, initially in one limb; face movements that simulate smirking expressions, anxiety; impairment of memory and sometimes of speech. May be associated with emotional instability and inappropriate behaviour. Movements cease during sleep. Recovery takes place in 2 to 6 months. Besides in rheumatic fever, it has also been reported in association with hyperthyroidism, systemic lupus erythematosus and some other common erythemas.
Chorea may be difficult to treat. According to reports, certain anti-epileptic medications may help to improve the symptoms of chorea.
The mainstay of treatment in adults is the class of neuroleptics, including haloperidol and pimozide.
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