THE CAUSES OF SPORADIC AND SENILE CHOREA

Background: Although 'senile' chorea is commonly listed in the differe ntial diagnosis of chorea, the condition is poorly defined. Indeed, th e existence of such an entity is debated. There are few contemporary p rospective studies of sporadic chorea in the elderly. Methods: Detaile d prospective study of patients presenting with undiagnosed chorea ove r a three year period to a Movement Disorder Clinic. Results: Twelve p atients, aged 50 to 89 years, were identified. The final diagnoses wer e Huntington's disease, confirmed on genetic testing in six, antiphosp holipid antibody syndrome in two, and hypocalcaemia, tardive dyskinaes ia and basal ganglia calcification in each of the three remaining case s. Only one patient remained undiagnosed despite extensive investigati on. Conclusions: The majority of patients with 'senile' chorea actuall y have Huntington's disease even in the absence of a family history. R arer causes of chorea still need to be considered in the elderly when Huntington's disease has been excluded by DNA analysis.