Differential Diagnosis for New Onset Chorea
Single Most Likely Diagnosis
- Huntington's Disease: This is a common cause of adult-onset chorea, characterized by an expansion of CAG repeats in the Huntingtin gene, leading to progressive damage to the basal ganglia.
Other Likely Diagnoses
- Vascular Causes: Strokes, particularly those involving the basal ganglia, can cause chorea. The onset is usually sudden and may be accompanied by other focal neurological deficits.
- Medication-Induced Chorea: Certain medications, such as antipsychotics, antidepressants, and anti-epileptics, can induce chorea as a side effect.
- Infectious Causes: Encephalitis, meningitis, or brain abscesses can cause chorea, especially if the basal ganglia are involved.
- Autoimmune Disorders: Conditions like systemic lupus erythematosus (SLE) or antiphospholipid syndrome can cause chorea due to autoimmune-mediated damage to the brain.
Do Not Miss Diagnoses
- Wilson's Disease: A genetic disorder leading to copper accumulation in the brain, which can cause chorea, among other neurological symptoms. Missing this diagnosis can lead to severe brain damage and death if not treated promptly.
- Creutzfeldt-Jakob Disease: A rare, fatal neurodegenerative disorder that can present with chorea, among other rapid neurological deteriorations.
- Neurosyphilis: Tertiary syphilis can cause a range of neurological symptoms, including chorea. It is crucial to diagnose and treat to prevent further neurological deterioration.
Rare Diagnoses
- Benign Hereditary Chorea: A rare genetic disorder characterized by non-progressive chorea, often presenting in childhood.
- Chorea-Acanthocytosis: A rare genetic disorder characterized by chorea and abnormal red blood cells (acanthocytosis).
- Pantothenate Kinase-Associated Neurodegeneration (PKAN): A rare genetic disorder leading to iron accumulation in the brain, causing progressive neurological deterioration, including chorea.
- Fahr's Disease: A rare, inherited disorder characterized by abnormal calcification of the brain, leading to a variety of neurological symptoms, including chorea.