Sertraline-induced Hemichorea

Gatto, Emilia; Aldinio, Victoria; Parisi, Virginia; Persi, Gabriel; Prat, Gustavo Da; Bullrich, María Bres; Sánchez, Pilar; Rojas, Galeno

doi:10.5334/tohm.367

Cited by 4 publications

(3 citation statements)

References 11 publications

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“…The most common cause of drug-induced asymmetric chorea is secondary to levodopa use in patients with idiopathic Parkinson’s disease who develop dyskinesia, however, this is outside of the scope of this review. Multiple other medications have been identified as causing an asymmetric or hemichorea including gabapentin [ 113 ], valproate [ 114 ], amphetamine [ 115 ], anti-histamine [ 116 117 ], selective serotonin reuptake inhibitors [ 118 ], neuroleptics [ 119 ] and z-drugs [ 120 ]. As previously mentioned, oral estrogen has been associated with drug-induced chorea as well, although this appears to be through a specific hormonal mechanism [ 105 106 107 108 109 ].…”

Section: Resultsmentioning

confidence: 99%

One Side of the Story; Clues to Etiology in Patients with Asymmetric Chorea

Cincotta¹,

Walker

2022

Tremor and Other Hyperkinetic Movements

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Background: Chorea can be due to a large number of etiologies. Unilateral chorea is classically related to a contralateral structural lesion, e.g. of the putamen or subthalamic nucleus, however, based upon personal impressions, we have observed that systemic disease, in particular metabolic or autoimmune conditions, can also lead to a unilateral or markedly asymmetric presentations. We sought to investigate this impression by reviewing the literature. Methods: A PubMed search was conducted using the terms asymmetric” AND “chorea” OR “hemichorea” OR “unilateral” AND “chorea” OR “monochorea” OR “right greater than left” AND “chorea” OR “left greater than right” AND “chorea” OR “right more than left” AND “chorea” OR “left more than right” AND “chorea” as well as “hemiballismus” NOT “stroke” NOT “infarct” NOT “dyskinesia. A total of 243 sources were felt to meet criteria and were reviewed. Results: The most common etiology of reported hemi- or asymmetric chorea was diabetic non-ketotic hyperglycemic hemichorea/hemiballismus. Other common diagnoses were Sydenham’s disease, antiphospholipid syndrome and drug-induced chorea. The vast majority of patients with hemi- or asymmetric chorea had acquired rather than genetic, degenerative or congenital causes. Conclusion: Despite the potential limitations of our literature review, the evidence presented here supports the observation that the vast majority of asymmetric or unilateral chorea presentations are due to acquired causes, and in this situation an exhaustive search for reversible etiology should be undertaken. However, presentation with symmetric, generalized chorea does not exclude reversible causes, and investigations should address these in addition to genetic and neurodegenerative etiologies.

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Section: Resultsmentioning

confidence: 99%

One Side of the Story; Clues to Etiology in Patients with Asymmetric Chorea

Cincotta¹,

Walker

2022

Tremor and Other Hyperkinetic Movements

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“…Chorea may be a side effect of many drugs especially neuroleptics, but also, less commonly, anticonvulsants, anticholinergics, antidepressants and opioids [8,10,[28][29][30][31]. Four out of 6 patient were taking several drugs.…”

Section: Discussionmentioning

confidence: 99%

The enduring enigma of sporadic chorea: A single center case series

Garcia Ruiz,

Feliz,

Feliz

et al. 2023

Tremor and Other Hyperkinetic Movements

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Chorea can have a wide variety of causes including neurodegenerative, pharmacological, structural, metabolic, infectious, immunologic and paraneoplastic processes.We reviewed the clinical records of patients with apparently sporadic choreic movements and no relevant family history, who presented to our neurology department (Hospital Fundación Jimenez Diaz) between 1991 and 2022.We detected 38 cases of apparent sporadic chorea (ASC); Our analysis revealed 5 cases of genetic chorea (including 3 cases with Huntington´s disease) while 6 cases were autoimmune/hematological; 6 drug-related chorea, 5 metabolic-vascular, 5 due to miscellaneous conditions and 4 were of mixed etiology. No clear etiology was identified in 8 cases. The differential diagnosis of ASC is extensive and challenging. Highlights• Chorea can have a wide variety of genetic and sporadic causes• We reviewed the clinical records of patients with apparently sporadic chorea (ASC), who presented to our neurology department over the last 30 years • We detected 38 cases of apparent ASC; Our analysis revealed a wide array of different sporadic conditions and 5 cases of genetic chorea • The differential diagnosis of ASC is extensive and challenging Garcia Ruiz et al. Tremor and Other Hyperkinetic Movements

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“…Other agents linked to chorea include valproic acid, lamotrigine, and other antiseizure medications, 105 106 107 108 109 110 111 selective serotonin reuptake inhibitors, 112 fluoroquinolones, 113 114 cough syrup, 115 and “z-drugs” (non-benzodiazepine hypnotics including zolpidem, zopiclone, and zaleplon). 116 In some of these situations, it has been surmised that there may have been an underlying vulnerability such as a structural lesion, or unrecognized genetic or metabolic factors.…”

Section: Differential Diagnosismentioning

confidence: 99%

Diagnostic Uncertainties: Chorea

Cincotta

Walker

2023

Semin Neurol

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Chorea is a hyperkinetic movement disorder with a multitude of potential etiologies, both acquired and inherited. Although the differential diagnosis for new-onset chorea is extensive, there are often clues in the history, exam, and basic testing that can help to narrow the options. Evaluation for treatable or reversible causes should take priority, as rapid diagnosis can lead to more favorable outcomes. While Huntington's disease is most common genetic cause of chorea, multiple phenocopies also exist and should be considered if Huntington gene testing is negative. The decision of what additional genetic testing to pursue should be based on both clinical and epidemiological factors. The following review provides an overview of the many possible etiologies as well as a practical approach for a patient presenting with new-onset chorea.

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Sertraline-induced Hemichorea

Cited by 4 publications

References 11 publications

One Side of the Story; Clues to Etiology in Patients with Asymmetric Chorea

One Side of the Story; Clues to Etiology in Patients with Asymmetric Chorea

The enduring enigma of sporadic chorea: A single center case series

Diagnostic Uncertainties: Chorea

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