Drug-induced chorea
ICD-10 G25.4 is a billable code used to indicate a diagnosis of drug-induced chorea.
Drug-induced chorea is a movement disorder characterized by involuntary, irregular, and non-repetitive movements that can affect various parts of the body. This condition is often a side effect of certain medications, particularly those that influence dopaminergic pathways in the brain. It is commonly associated with the use of antipsychotic medications, particularly first-generation antipsychotics, which can lead to extrapyramidal symptoms, including chorea. Patients may present with sudden onset of abnormal movements, which can be distressing and may interfere with daily activities. The pathophysiology involves alterations in the basal ganglia circuitry, particularly affecting the balance of dopamine and acetylcholine. In the context of Parkinson's disease, where dopaminergic medications are frequently used, the risk of developing drug-induced chorea increases, especially when there is an abrupt change in medication or dosage. Accurate diagnosis requires a thorough medication history and clinical evaluation to differentiate drug-induced chorea from other movement disorders, such as Huntington's disease or primary dystonia. Treatment typically involves adjusting the offending medication and may include the use of anticholinergic agents or other medications to manage symptoms.
Detailed neurological examination findings, medication history, and response to treatment.
Patients presenting with new-onset chorea after starting or changing medications.
Neurologists should document the timeline of medication changes and any other contributing factors.
Comprehensive psychiatric evaluation, including medication management history.
Patients experiencing chorea while on antipsychotic medications.
Psychiatrists must ensure clear documentation of the relationship between medication changes and the onset of symptoms.
Used when evaluating a patient with drug-induced chorea.
Document history, examination findings, and medication review.
Neurologists and psychiatrists should ensure comprehensive documentation to support the visit level.
Common medications include first-generation antipsychotics like haloperidol, second-generation antipsychotics like risperidone, and certain antiemetics such as metoclopramide. It's crucial to review the patient's medication history to identify potential causative agents.
