The term chorea (pronounced like the country Korea) is derived from the Greek term for dancing. Medically, the term is used to describe an involuntary writhing movement of part of the body that may appear to be dance-like. Unlike dancing, however, these movements are neither rhythmic nor repetitive, and they are decidedly unpleasant.

In fact, chorea can hinder every day movements, making it difficult to use hands or arms, and may be so severe that walking becomes impossible. Furthermore, chorea can be a sign of symptom of serious neurological diseases.

For example, chorea is often associated with Huntington's disease, a dreaded neurodegenerative disorder. It can also signify other genetic diseases like Wilson's disease or neuroacanthocytosis.

Sometimes, chorea is caused by something that happens after you're born. About 20 percent of children who have rheumatic fever develop Sydenham's chorea. Chorea can also result from stroke or diffuse hypoxic injury to the brain, or as a side effect from medications like anti-psychotics, anti-convulsants, and levodopa.

Treating chorea depends on the underlying cause. For Huntington's chorea, tetrabenazine is FDA approved. Other treatments for chorea include anti-psychotic medications like Haldol. Sedatives like diazepam can also be tried. A symptom like chorea should never be ignored, and requires evaluation by a physician.

The internet is everywhere these days. With Facebook, Twitter, blogging, podcasts and more, the internet continues to become part of our everyday lives. But as a growing field called "telestroke" demonstrates, the internet can also plays a role in emergency situations as well.

When blood is blocked to the brain, neurons die at a rate of about 2 million a minute. The sooner blood flow is restored, the greater the likelihood of a good recovery. The best way to restore blood flow is with a drug called tissue-plasminogen activator (tPA), which breaks up blood clots. However, tPA can only be used within the first few hours after a stroke.

The management of stroke within the first few hours puts unusual amount of strain on physicians' abilities, and is a situation where a knowledgeable neurologist is invaluable. Since tPA can have serious side effects, many doctors are hesitant to use it, even though the benefits can be great. In fact, many fewer people receive this drug than could benefit from it. This is especially true in rural areas where no neurologists may be available to see patients with acute stroke.

Telestroke allows physicians to consult a neurologist over the internet, allowing video communication between the patient, primary doctor, and neurologist. In this way, the neurologist can advise whether and how to give treatment like tPA. Studies have shown that telestroke is cost-effective compared with conventional care, and that it increases the use of tPA.

Just because the medication can be given in a rural area doesn't mean the patient should remain at that initial care center, however. People with stroke tend to do better in hospitals that are dedicated stroke centers, with physicians and nurses specialized in neurological disease. However, telestroke permits this valuable medication to be given within a window of time that benefits the patient most, before they are transferred to such a hospital.

The technology of telestroke is developing rapidly. A team of researchers recently showed that iPhones could be used in the assessment of patients as well. Wherever you're reading this, a neurologist could virtually be at your side within seconds in case of emergency. When time is brain, that counts for a lot.

Blepharospasm is a kind of focal dystonia, meaning an involuntary tightening of muscles. In blepharospasm, those muscles are around the eyes, causing the eyelids to unintentionally shut. People with blepharospasm may also have photophobia, meaning an aversion to strong light, as well as a feeling of eye dryness. The disorder is often called benign essential blepharospasm, but this term has received criticism as blepharospam, while not life threatening, may be embarassing and impair one's life too much to be called benign, and it is hardly "essential."

Blepharospasm is relatively rare, and is not well understood. There is a theory that, like other dystonias, blepharospasm may be due to a dysfunction of the basal ganglia, but this has not been absolutely proven. Blepharospasm may evolve to include other dystonias as well, such as torticollis.

The risk of developing blepharospasm tends to increase as we get older. The average age that blepharospasm begins is about 55 years. While the risk factors for blepharospasm aren't really well known, it appears that drinking coffee earlier in life may protect against developing blepharospasm later. There may also be an inherited risk, as people with blepharospasm may have other forms of dystonia within their family.

The main treatment of blepharospasm involves injections of botulinum toxin (Botox) into the eyelids and eyebrows. In more severe cases that do not respond to botulinum toxin, surgical treatments like muscle ablation (myomectomy) to weaken the tightening muscles or deep brain stimulation may be helpful. The best treatment of blepharospasm requires close conversation and cooperation with a medical professional like a neurologist.

_Source:

_{Mark Hallett, Craig Evinger, Joseph Jankovic, Mark Stacy. Update on blepharospasm. Report from the BEBRF International Workshop. Neurology 71, October 14, 2008, 1275-1282}

The idea that music might have healing properties isn't new. The ancient Greek god Apollo, pictured above, was god of both medicine and music. For the most dramatic ancient anecdote about music's healing power, consider Orpheus, who almost successfully used his musical prowess to rescue his love from death itself.

There's no question that music has a unique power on our nervous systems. Otherwise we wouldn't enjoy it so much. More objective measurements can be taken of our heart rate, respiratory rate, and skin conductance when listening to music we enjoy, demonstrating how music is even affecting our unconscious autonomic nervous system. So can music be used to treat neurological disease as well?

Music therapists try to use music's healing properties to help people with several kinds of illnesses, including neurological diseases. In some cases, there have been clear successes. Music therapy can help improve stress and depression, both of which can be damaging to health. Music therapy has also been suggested to improve the quality of life of many people with diseases like Alzheimer's, and may improve recovery of people with stroke.

Of course, this is not to say that music should replace medical therapy for most medical diseases. It would be a serious mistake, for example, to attempt to treat meningitis with an aria instead of an antibiotic. But because the brain is responsible for our psychology, diseases that affect the brain often change our mood and even our personality for the worse. At the very least, music can improve our quality of life, and this is the ultimate goal of medicine as well.

For more information about music therapy and the brain, read here:

• Benefits of Music Therapy
• How and Why Music Therapy is Effective
• Your Musical Mind