Movement disorders identified in patients with intracranial tuberculomas

Alarcón, Fernando; MALDONADO, J; Rivera, José W

doi:10.1016/s2173-5808(11)70080-3

Cited by 7 publications

(8 citation statements)

References 16 publications

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“…The rarity of TB cerebritis may be attributed to its delayed clinical presentation, which typically only manifests when mass effect ensues [ 42 ]. This case also demonstrates that a deep location as well as the presence of multiple focal tuberculous lesions may influence the appearance of movement disorders as suggested in Alarcón’s cohort of 49 patients with tuberculoma [ 28 ]. Although we believe that both infections were contributory to the HCHB at the time of presentation, one limitation encountered was the lack of baseline neuroimaging, CD4 count and HIV viral load at the time of initial HIV and TB diagnosis, which could have helped elucidate the temporality of these infections in relation to HCHB.…”

Section: Discussionmentioning

confidence: 67%

“…Currently, there are no studies describing their interplay as an underlying mechanism for HCHB, whether in the presence or absence of HIV infection. Acute disruption and altered firing rate of the STN and its efferent pathways due to a destructive focus, in addition to the direct effects of HIV on the basal ganglia circuitry, possibly contribute to the pathogenesis of chorea-ballism in this population [ 2 20 27 28 37 43 ]. As is usually the case among AIDS patients, multiple conditions may affect a portion of the nervous system simultaneously [ 36 ] and it is imperative to address these with adequate antimicrobial therapy.…”

Section: Discussionmentioning

confidence: 99%

“…HIV-infected adults are 21–37 times more likely to acquire tuberculosis in particular [ 35 ], and those with systemic TB are five times more predisposed to have central nervous system involvement [ 35 ]. Although rare, HCHB may be secondary to intracranial TB complicated by infarctions, TB abscess or tuberculomas as seen in Table 1 [ 25 28 ]. There is limited literature documenting HCHB as a result of opportunistic co-infections of toxoplasmosis and TB in HIV/AIDS patients.…”

Section: Introductionmentioning

confidence: 99%

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Hemichorea-Hemiballismus as a Presentation of Cerebritis from Intracranial Toxoplasmosis and Tuberculosis

Dimal

Santos

Reyes

et al. 2021

Tremor and Other Hyperkinetic Movements

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Background: There is limited literature documenting hemichorea-hemiballism (HCHB) resulting from co-infection of toxoplasmosis and tuberculosis (TB) in acquired immunodeficiency syndrome (AIDS). Toxoplasmic abscess is the most common cause while TB is a rare etiology. Case Description: We describe a 24-year-old male with AIDS-related HCHB as the presentation of cerebritis on the right subthalamic nucleus and cerebral peduncle from intracranial toxoplasma and TB co-infection. Antimicrobials and symptomatic therapy were given. Marked improvement was seen on follow-up. Discussion: HCHB may be the initial presentation of intracranial involvement of this co-infection in the setting of AIDS and is potentially reversible with timely management. Highlights: Hemichorea-hemiballismus (HCHB) may be an initial presentation of intracranial involvement of concomitant toxoplasmosis and tuberculosis causing focal cerebritis in the contralateral subthalamic nucleus and cerebral peduncle, particularly in the setting of human immunodeficiency virus infection. Acquired immunodeficiency syndrome-related HCHB is potentially reversible with timely diagnosis and treatment.

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Section: Discussionmentioning

confidence: 67%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Hemichorea-Hemiballismus as a Presentation of Cerebritis from Intracranial Toxoplasmosis and Tuberculosis

Dimal

Santos

Reyes

et al. 2021

Tremor and Other Hyperkinetic Movements

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“…Chorea may appear during the hyper or hyponatremic phase or after correction of the electrolyte disturbance [112]. Chorea in association with hyponatremia has been repor ted in intracranial tuberculomas [113]. A rapid correction of hyponatremia can cause central pontine and extrapontine myelinolysis which can also cause movement disorders [114][115][116].…”

Section: Hypocalcemiamentioning

confidence: 99%

Review of Hereditary and Acquired Rare Choreas

Martínez-Ramírez

Walker

Rodríguez-Violante

et al. 2020

Tremor and Other Hyperkinetic Movements

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The first step in diagnosis is recognizing the movement disorder as chorea [1]. Chorea is characterized by irregu lar, purposeless, arrhythmic, nonstereotyped involuntary movements that flow from one body part to another [2]. These movements can affect any part of the body, although usually brief, can also be of long duration, and can have small or large amplitude. Movements with large amplitude localized proximally in the arms are called "ballismus" [3]. Once the movement disorder has been recognized as chorea, we then recommend classifying the age of onset as either childhood (prior to the age of 16) or adultonset [1]. Multiple causes of chorea exist in both age groups, many of which fit in the definition of rare diseases [4]. Since the most common cause of acute chorea in childhood is Sydenham's chorea and of chronic progressive chorea in adults is Huntington's disease (HD), we recommend these disorders should be tested for, as appropriate, and excluded before proceeding to other diagnostic pathways. The next step is to determine, if possible, whether the chorea is hereditary (genetic) or acquired (nongen etic) in nature. The family history should be carefully and

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“…or specific infections such as movement disorders in human immunodeficiency virus infection, tuberculosis, neurocysticercosis, post infectious cerebellar ataxia etc. [5] , [6] , [7] , [8] , [9] . However, literature on IRMD prevalence, pattern, prognosis and management as a whole is lacking [1] , [4] , [10] , [11] .…”

Section: Introductionmentioning

confidence: 99%