Chorea and Huntington’s: Understanding the connection

Last updated Jan. 15, 2025, by Agata Boxe
Fact-checked by Patrícia Silva, PhD

While many people with Huntington’s disease experience chorea — involuntary muscle movements that can resemble dancing — the involuntary movements are not the same as the disease. While they are a common symptom of Huntington’s, the condition does not always involve them.

Huntington’s disease is a hereditary progressive neurodegenerative disorder that often causes involuntary movements, loss of cognitive ability, and behavioral changes. Besides the involuntary jerky movements that characterize chorea, other movement-related conditions seen in people with Huntington’s include akathisia (restlessness) or dystonia, which are muscle spasms or contractions.

Chorea is one of the early physical signs of Huntington’s. Learning about its causes, effects, and treatment options can help you recognize and manage chorea the best you can.

The difference between chorea and Huntington’s disease

The main difference between Huntington’s disease and chorea is that chorea is not a disease but a symptom of Huntington’s and other diseases. The involuntary muscle movements can also be caused by other factors such as medications and exposure to some toxins.

Other causes of chorea include: 

• Parkinson’s disease or another neurological movement disorder
• autoimmune diseases such as lupus or multiple sclerosis
• hyperthyroidism
• pregnancy
• brain tumor
• reaction to some medications
• carbon monoxide or mercury poisoning.

Though people with Huntington’s often experience chorea, there are other common Huntington’s disease symptoms, including:

• cognitive impairment
• walking difficulties
• problems with speech
• swallowing issues
• difficulty thinking, planning, and organizing.

How chorea affects the body

Chorea symptoms can affect you in many ways. Chorea can be physically and mentally taxing as well as distracting.

Chorea involves brief, abrupt involuntary movements that often appear to flow from one body part to another, but they can also occur in just one area in the body.

The movements can interfere with chewing, swallowing, speech, posture, and walking. Clumsiness that often occurs with chorea can cause you to repeatedly drop objects and have a higher risk of injury.

Chorea can also contribute to weight loss because it causes the body to use more energy.

Experiencing chorea may affect your mental health as well, and so can some of the medications used to treat movement disorders.

Causes of chorea in Huntington’s disease

People with Huntington’s are susceptible to chorea because of the genetics of the disease and the neurotransmitter imbalances it causes.

The gene mutation that causes the disease leads to the degeneration of neurons, including those that control and coordinate movement and posture, located at the basal ganglia region, deep within the brain.

This degeneration affects the levels of dopamine, a neurotransmitter that is involved in regulating movement.

Treating Huntington’s-related chorea

Because of dopamine’s role in Huntington’s disease, chorea treatment  usually involves medications that target the neurotransmitter or pathways associated with it. Physical and occupational therapies may be part of your treatment plan as well.

The medications to treat chorea in Huntington’s disease, such as tetrabenazine, help to reduce chorea by decreasing dopamine levels.

Chorea can also be treated with antipsychotic medications, which often block dopamine receptors and help reduce movements while also managing psychiatric symptoms — such as irritability and psychosis — that may accompany chorea.

Physical and occupational therapy may also be recommended to complement your medication treatment plan.

For example, physical therapy can help you prevent falls, which are common with chorea, by doing exercises that try to improve balance. A physical therapist can also teach you how to use assistive devices such as walkers or canes if you need them.

Occupational therapy can help you with doing everyday activities of living, such as getting dressed, eating, and showering, which can be challenging with chorea. An occupational therapist can also recommend strategies to try to prevent injury from falling. For example, they may be able to suggest the best types of padding for hard surfaces.

If you feel like chorea is affecting your mental health, consider talking to a therapist.

Breathing and relaxation techniques, social support, and fun hobbies — such as reading, board games, and puzzles — are other ways to help manage chorea’s potential impact on your emotional well-being.

Can you have Huntington’s disease without chorea?

Chorea is not just a symptom of Huntington’s disease — ​other diseases can cause chorea. The opposite can be true as well: You can have Huntington’s disease without chorea.

For example, some people with Huntington’s do not develop chorea but instead become rigid and have difficulty moving — a condition called akinesia.

Others may experience chorea in the early stages, but with Huntington’s disease progression they may start experiencing rigidity.

In people with juvenile-onset Huntington’s disease, which is when patients are younger than 20, rigidity and seizures are more common than chorea.

If you think you have Huntington’s disease symptoms or chorea, you should consult a doctor as soon as possible.

Learn more about Huntington’s disease, its symptoms, and treatment by visiting Huntington’s Disease News.

Huntington’s Disease News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.