Movement - unpredictable or jerky

Alternative names 
Jerky body movements; Chorea; Muscle - jerky movements (uncontrolled)

Definition
A condition in which uncontrolled, purposeless, rapid motions interrupt normal movement or posture.

Considerations
Typical movements of chorea (called tics) include facial grimacing, raising and lowering the shoulders, bending and extending the fingers and toes. The condition can affect one or both sides of the body.

These involuntary movements are generally not repetitive and can appear purposeful even though they are involuntary and uncontrollable. A person with chorea may be mistaken for jittery or restless.

Common Causes

There are many possible causes of unpredictable, jerky movements which include Sydenham’s chorea, Huntington disease and other rare disorders. Some medical illnesses that can cause chorea include anti-cardiolipin antibody syndrome, systemic lupus erythematosis, polycythemia rubra vera, stroke, thyroid disease, and disorders of calcium, glucose or sodium metabolism.

Some medications such as anti-psychotic drugs, may cause tardive dyskinesia, a movement disorder which may include choreic movements. Rarely, it is inherited in the syndrome called benign hereditary chorea. Some women may develop chorea when pregnant. This is called chorea gravidarum.

Home Care
Therapy is aimed at identifying and treating the underlying cause. If it is due to medication, the drug should be discontinued if possible. If it is due to medical disease, the disorder should be treated. If the movements are severe and disruptive, several medications such as amantadine or tetrabenazine may help control the movements.

Rest helps improve chorea and it can be aggravated by excitement or fatigue. Emotional stress should be minimized.

Safety measures should also be taken to decrease the likelihood of injury from the involuntary movements.

Call your health care provider if

     
  • there is any persistent, unexplained, and uncontrollable bodily motions.

What to expect at your health care provider’s office
The medical history will be obtained and a physical examination performed.

Medical history questions documenting this symptom in detail may include:

     
  • Type       o What kind of movement occurs?       o What part of the body is affected?  
  • Other       o What other symptoms are also present?       o Is there irritability?       o Is there weakness or paralysis?       o Is there restlessness?       o Is there emotional instability?       o Are there facial tics?

The physical examination should include an extensive neurological and muscular system examination.

After seeing your health care provider:
You may want to add a diagnosis related to chorea to your personal medical record.

Johns Hopkins patient information

Last revised: December 7, 2012
by Mamikon Bozoyan, M.D.

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All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.