What is Chorea-Acanthocytosis?

Chorea-Acanthocytosis Explained: Genetics, Symptoms & Care Strategies

Chorea-acanthocytosis is a rare inherited condition that disrupts normal body functions. It mainly affects physical and neurological health, leading to challenges in everyday activities and potentially disrupting quality of life.

Beyond the physical symptoms, the disorder can also impact emotional health and social relationships, as movement and coordination difficulties may interfere with daily interactions. Thus, it is crucial to understand its causes and symptoms for early detection and proper treatment.

Keep reading to learn the types of chorea-acanthocytosis, its causes, symptoms and other relevant details.

What are the Different Types of Chorea-Acanthocytosis?

Chorea-acanthocytosis can take several forms, each involving a combination of movement issues, psychiatric symptoms, and blood cell abnormalities, such as:

• Classic Chorea-Acanthocytosis: This form features involuntary movements (chorea), spiky-shaped red blood cells (acanthocytes), and various neurological symptoms.
• McLeod Syndrome: McLeod syndrome is a separate X-linked condition with overlapping symptoms, including acanthocytosis and movement disorders.
• Huntington Disease-Like 2 (HDL2): This form is similar to Huntington disease, presenting chorea and cognitive deterioration as its main features.
• Levine-Critchley Syndrome: A rare form that encompasses movement disorders, psychiatric problems and slow deterioration of mental functions.
• NEAP (neuroendocrine-associated phosphatase) Variant: This form is marked by unique genetic mutations, resulting in specific movement abnormalities and changes in blood cell structure.

What are the Causes of Chorea-Acanthocytosis?

Chorea-acanthocytosis can result from various factors, some of which are short-term, while others are long-lasting. These include:

What are the symptoms of chorea-acanthocytosis?

Chorea-acanthocytosis usually appears with a mix of movement issues and abnormalities in blood cells. Common symptoms include:

• Involuntary jerky movements (chorea)
• Abnormal spiky red blood cells (acanthocytosis)
• Limb spasms
• Muscle weakness (myopathy)
• Cognitive impairment (problems with learning, memory, and information processing)
• Peripheral neuropathy (numbness, reduced sensation, and weakness in arms and legs)
• Involuntary muscle contractions (dystonia) affecting limbs, face, mouth, tongue, and throat
• Vocal tics such as grunting and involuntary belching
• Seizures (affecting nearly half of individuals)
• Self-injurious behaviours like biting the tongue, lips, and the inside of the mouth
• Difficulty chewing and swallowing due to tongue and throat spasms
• Speech difficulties, which may progress to complete inability to speak
• Obsessive-compulsive behaviours (OCD)
• Poor impulse control and difficulty with self-care
• Behavioural and personality changes

What are the treatments for chorea-acanthocytosis?

The treatment of chorea-acanthocytosis focuses on managing symptoms and improving the patient’s overall well-being through a comprehensive care approach. Listed below are some of the standard treatment options:

1.  Medications

Certain medications may be prescribed to help control involuntary movements linked to chorea-acanthocytosis. Several medications may help manage the movement symptoms of chorea-acanthocytosis by targeting dopamine pathways. These include:

• Dopamine Receptor Blockers: Haloperidol (Haldol), fluphenazine (Prolixin), olanzapine (Zyprexa), quetiapine (Seroquel), and risperidone (Risperdal). Although primarily used as antipsychotics, these drugs can help reduce chorea symptoms and may be prescribed off-label.
• Dopamine-Depleting Agents: Reserpine and tetrabenazine (Xenazine) work by reducing dopamine levels in the brain, which helps manage involuntary movements.
• Benzodiazepines: Clonazepam (Klonopin) may also be used to help lessen chorea.

2.  Physical Therapy

Physical therapy can help strengthen muscles, improve coordination and balance, and reduce the likelihood of falls.

3.  Speech Therapy

Speech therapy plays a key role in addressing speech difficulties and problems with swallowing that some individuals may experience.

4.  Psychological Support

Counselling and psychological therapy can offer emotional support to both patients and their families, helping them cope with the mental and emotional effects of the disorder.

5.  Nutritional Support

Maintaining adequate nutrition and hydration is vital for managing symptoms and promoting general health.

What are the complications of chorea-acanthocytosis?

As chorea-acanthocytosis progresses, it can lead to serious complications in some individuals, including:

• Loss of the ability to walk independently, often resulting in being confined to a wheelchair or bedridden.
• Severe injuries to the lips and tongue caused by uncontrollable biting.
• Complete loss of speech or the inability to speak.
• Dementia is an ongoing decline in memory and cognitive abilities.

Chorea-acanthocytosis is a complex, rare disorder that affects many aspects of a person’s physical, neurological, and emotional health. Early diagnosis and comprehensive care can help manage symptoms and improve quality of life.

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