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A case of late-onset chorea

Nature Clinical Practice Neurology volume 1, pages 113–116 (2005)Cite this article

Abstract

Background A 75-year-old woman with rheumatoid arthritis presented with a 4-year history of chorea to a hospital movement disorder clinic. The involuntary movements were initially mild, affecting only the right side of the body, but gradually worsened and became bilateral. There was no relevant family history. Medications included hormone replacement therapy (HRT), diclofenac sodium, vitamin D, folic acid, methotrexate and zopiclone. On examination, bilateral choreiform movements were seen, affecting the face and limbs, with the right side more severely affected than the left.

Investigations Neuropsychological testing, laboratory blood and DNA testing, echocardiogram, MRI of the brain, and brain perfusion single-photon emission computed tomography (SPECT) scanning.

Diagnosis HRT-related chorea, possibly caused by a predisposition secondary to rheumatoid arthritis and small-vessel ischemic disease, or subclinical childhood rheumatic fever.

Management Discontinuation of HRT.

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Authors and Affiliations

  1. Director of the Movement Disorders Program in the Department of Clinical Neurosciences at the University of Calgary/Calgary Health Region, Calgary, Alberta, Canada

    Oksana Suchowersky

  2. consultant neurologist at the Ashwani Hospital in Kerala, India

    Joy Muthipeedika

Authors
  1. Oksana Suchowersky
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  2. Joy Muthipeedika
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Corresponding author

Correspondence to Oksana Suchowersky.

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The authors declare no competing financial interests.

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Suchowersky, O., Muthipeedika, J. A case of late-onset chorea. Nat Rev Neurol 1, 113–116 (2005). https://doi.org/10.1038/ncpneuro0052

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  • DOI: https://doi.org/10.1038/ncpneuro0052

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