Objective: The aim of this poster is to provide a tool to facilitate diagnosis of chorea. This flow chart has been presented at previous MDS meetings and continues to be a popular and evolving resource for movement disorders clinicians.

Background: Chorea is a common movement disorder, the etiology of which is rarely identifiable from its appearance. The identification of genetic causes for some of the inherited choreas has facilitated diagnosis, in addition to increasing the spectrum of phenotypes for other disorders in which chorea may occur less often. Despite advances in molecular diagnosis, the diagnosis can be challenging. A number of clues in the family and medical history, clinical examination, and laboratory findings may inform the diagnosis. Whilst we often consider these simultaneously when evaluating the patient with chorea, there is a need for an algorithm to generate consideration of some of the rarer etiologies.

Method: We present an updated version of the flow chart, initially developed eleven years ago, to facilitate the diagnosis of chorea, based upon the current literature. We present the various factors which facilitate making the correct diagnosis and the appropriate testing to consider depending upon previous test results. These include inheritance patterns, additional neurological and non-neurological clinical features, neuroimaging results, routine and specialized laboratory testing.

Results: The resulting flow chart is presented as a poster, and conference attendees are encouraged to comment upon and amend it in the light of additional information from their own experience.

Conclusion: The list of differential diagnoses of chorea is ever-evolving with advances in the molecular biology of movement disorders. Here we present an updated algorithm which is open to further development in the light of new knowledge. This flow chart does not necessarily indicate the temporal course of the diagnostic work-up of chorea, but should be used a guideline to generate the consideration of various clinical entities in light of the available information.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/an-updated-flow-chart-for-the-evaluation-of-chorea/