Chorea and ballism
Usually, chorea treatment is directed at its cause. For example, drug-induced chorea in Parkinson disease is treated differently from severe chorea in Huntington disease. See also advice on Sydenham chorea.
Chorea often does not need treatment and resolves spontaneously in some cases (eg poststroke hemiballism, chorea gravidarum).
The general approach to drug therapy for chorea is to block postsynaptic dopamine (D2) receptors, deplete dopamine or increase gamma-aminobutyric acid neurotransmission. For prolonged treatment, dopamine receptor–blocking drugs are avoided because they can cause tardive syndromes; a dopamine depletor (ie tetrabenazine) may be used. Refer for expert advice.
To treat severe chorea in an emergency setting, try a dopamine receptor–blocking drug. Use:
1 chlorpromazine 25 mg orally, once or twice daily chorea and ballism chlorpromazine
OR
1 haloperidol 1 to 2 mg orally, up to 4 times daily. chorea and ballism haloperidol