Cause and course in a series of patients with sporadic chorea

Piccolo, I.; Defanti, C. A.; Soliveri, Paola; Volontè, Maria Antonietta; Cislaghi, Giuliana; Girotti, F.

doi:10.1007/s00415-003-1010-7

Cited by 93 publications

(62 citation statements)

References 29 publications

(28 reference statements)

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“…The HD is a more common presentation compared to others. The HIV infection (specially, no family history of movement disorders in younger), vascular causes and drugs are not common (2,3).…”

Section: Dear Editormentioning

confidence: 99%

Ballistic Movements and Psychotic Symptoms due to Methadone Use: A Letter to the Editor

Bidaki

Yazdian

2015

Thrita

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“…The HD is a more common presentation compared to others. The HIV infection (specially, no family history of movement disorders in younger), vascular causes and drugs are not common (2,3).…”

Section: Dear Editormentioning

confidence: 99%

Ballistic Movements and Psychotic Symptoms due to Methadone Use: A Letter to the Editor

Bidaki

Yazdian

2015

Thrita

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“…The other genetic conditions causing chorea (Table 20.2) are quite rare. One study of consecutive patients with non-genetic forms of chorea seen at a tertiary hospital found that stroke accounted for 50% of all cases, drug abuse was identified in one-third of the patients, while the remaining patients had chorea related to AIDS and other infections, as well as metabolic problems (Piccolo et al, 2003).…”

Section: Clinical Presentation and Prevalencementioning

confidence: 99%

“…Aside levodopa-induced chorea in Parkinson's disease, cerebro-vascular disease is the most common cause of non-genetic chorea (Piccolo et al, 2003). Nevertheless, chorea is an unusual complication of acute vascular lesion, seen in less than 1% of patients with acute stroke .…”

Section: Vascular Choreasmentioning

confidence: 99%

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Chorea

Cardoso¹

2008

Therapeutics of Parkinson's Disease and Other Movement Disorders

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“…A recent study found various ischemic, and one hemorrhagic, lesions in 21 of 51 (41%) consecutive cases of sporadic chorea. 3 Some of these lesions were in basal ganglia or thalami but they were thought to be the cause of chorea in only two patients. Carotid duplex ultrasonography was not reported so it is possible that some had undetected carotid artery stenosis.…”

mentioning

confidence: 98%

Pearls & Oy-sters: Resolution of hemichorea following endarterectomy for severe carotid stenosis

Galea¹,

Norwood²,

Phillips³

et al. 2008

Neurology

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We report three patients with hemichorea who were found to have contralateral atherosclerotic carotid artery stenosis. Their details are compared in the table. All patients had carotid duplex ultrasonography because they exhibited neurologic signs or symptoms suggestive of cerebrovascular ischemia in addition to chorea.Patient A developed right hemichorea; 9 months later she experienced three episodes of right limb weakness and speech disorder lasting 5 minutes, suggestive of transient ischemia. The severity of chorea increased and it mildly affected the left side. Neurologic examination revealed predominantly rightsided chorea and mild orofacial dyskinesia without other neurologic signs. The following blood tests were normal: full blood count, inflammatory markers, coagulation studies, renal, glucose, bone, liver, and thyroid biochemistry, immunoglobulin electrophoresis, anticardiolipin antibodies, and antinuclear antibodies screen (including extractable nuclear antigens). CT of the head was normal. Carotid duplex ultrasonography revealed 90% stenosis in the left internal carotid artery.Patient B developed right hemichorea and 3 months later expressive dysphasia and right facial and hand weakness; this precipitated admission. In addition to chorea, there was right visual inattention and upper motor neuron weakness affecting the right face and hand with normal reflexes and plantar responses. The same blood tests as for patient A were normal; in addition, treponemal serology was consistent with past infection. MRI of the brain showed a left-sided parietal lobe infarct which was limited to the gray matter of the posterior parietal lobe suggestive of watershed infarction. Carotid duplex ultrasonography revealed 90% stenosis in the left internal carotid artery.Patient C presented with right-sided upper limb cortical sensory loss (dysgraphesthesia, astereognosis, and joint position sense loss) and within a month had developed right hemichorea. A blood test panel as described above was normal. In addition, the following investigations were normal or negative: treponemal serology, copper, ceruloplasmin, antistreptolysin titers, rheumatoid factor, and anticytoplasmic nuclear antibodies. CSF examination was performed: cell count, protein, and glucose were within normal limits, herpes simplex virus PCR was negative, and oligoclonal bands were absent. MRI of the brain showed a left-sided parietal lobe infarct which involved the post-central gyrus and the underlying parietal white matter. Carotid duplex ultrasonography revealed 90% stenosis in the left internal carotid artery.All three patients proceeded to carotid endarterectomy with complete resolution of the chorea. Neurologic signs in patient B resolved, but right-sided cortical sensory loss persisted in patient C. DISCUSSION New onset chorea frequently triggers referral to neurology departments. Its several causes include metabolic, vascular, structural, autoimmune, and genetic. 1 Diagnostic workup therefore usually includes a detailed family and drug history, a general...

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Cause and course in a series of patients with sporadic chorea

Cited by 93 publications

References 29 publications

Ballistic Movements and Psychotic Symptoms due to Methadone Use: A Letter to the Editor

Ballistic Movements and Psychotic Symptoms due to Methadone Use: A Letter to the Editor

Chorea

Pearls & Oy-sters: Resolution of hemichorea following endarterectomy for severe carotid stenosis

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