Recurrent Hormone Dependent Chorea: Effects of Oestrogens and Progestogens

Abstract

A case of hemi-chorea is described in a young woman, initially following administration of an oral contraceptive pill and recurring in a subsequent early pregnancy. The chorea ceased with the removal of the aetiological factor on each occasion. Subsequent challenge with a combined oestrogen/progestogen pill resulted in recurrence of the chorea, but the patient has been successfully maintained on a progestogen without any further symptoms. Thus it would appear that oestrogen component was the precipitating factor for the chorea.

Contrasting Effects of Increased and Decreased Dopamine Transmission on Latent Inhibition in Ovariectomized Rats and Their Modulation by 17β-Estradiol: An Animal Model of Menopausal Psychosis?

“…Results consistent with both reduction and increase of striatal dopaminergic function by estradiol have been reported for all indices of dopaminergic activity, including receptor levels/binding, membrane dopamine transporter levels, and release, depending on dose and treatment paradigm (Arvin et al, 2000;Bazzett and Becker, 1994;Becker and Beer, 1986;Becker and Rudick, 1999;Di Paolo, 1994, 1982, 1984, 1985Disshon et al, 1998;Disshon and Dluzen, 2000;Dluzen, 1997;Landry et al, 2002;McDermott, 1993;McDermott et al, 1994;Morissette et al, 2008;Morissette and Di Paolo, 1993;Peris et al, 1991;Shieh and Yang, 2008;Thompson and Moss, 1994;Zhou et al, 2002). It has been suggested that antidopaminergic effects are primarily exerted by high doses of estrogen or chronic administration, whereas pro-dopaminergic actions are more associated with lower physiological levels of estrogen (Barber et al, 1976;Becker, 1999;Bedard et al, 1977;Cyr et al, 2002;Di Paolo, 1994;Di Paolo et al, 1981;Hruska and Silbergeld, 1980;McEwen and Alves, 1999;Riddoch et al, 1971). The specific mechanisms by which estradiol exerts the effects observed here remain to be elucidated.…”

Early Visual Processing over the Menstrual Cycle: The Tilt Aftereffect

“…Oestrogens are known to reduce the akinesias associated with both neuroleptics (dopamine receptor blocking drugs) and with L-dopa [7,9,39]. On the other hand, contra ceptive drugs containing oestrogens have been known to occasionally induce chorea [4,29,41 ]. The results of ani mal studies are equally unclear.…”

The influence of estrous cycle and intrastriatal estradiol on sensorimotor performance in the female rat

“…For example, a single low dose of estradiol can increase lingual dyskinesia [8], while chronic estrogen treatment reduces tardive dyskinesia [9,27]. There is also clinical evidence that high estrogen concentrations can influence basal ganglia function in a small population of (normal) women, by inducing choreiform disorders during pregnancy (Chorea Graviderum) and/or in association with birth control pill use [2,20,34], Elucidation of the mechanism(s) through which estrogen can modulate basal ganglia function may facilitate our understanding and treatment of these diseases.…”