Generalized Choreoathetosis in an Acquired Immune Deficiency Syndrome Patient with Cerebral Toxoplasmosis
Many hypokinetic and hyperkinetic movement disorders (e.g. parkinsonism, chorea, myoclonus, dystonia) are associated with acquired immune deficiency syndrome (AIDS) and may sometimes represent the initial manifestation of the illness. We described a 37-year-old human immunodeficiency virus (HIV)-infected patient with generalized choreoathetoid movements associated with AIDS. Cranial MRI revealed multiple cerebral and cerebellar abscesses. The diagnosis of toxoplasmosis was established by brain biopsy. Hemichorea and hemiballismus in AIDS patients are pathognomonic findings of cerebral toxoplasmosis. Generalized choreiform movement is a rare condition and related to the bilateral cerebral involvement in toxoplasma disease affecting the subcortical structures.
Generalized Choreoathetosis in an Acquired Immune Deficiency Syndrome Patient with Cerebral Toxoplasmosis
Many hypokinetic and hyperkinetic movement disorders (e.g. parkinsonism, chorea, myoclonus, dystonia) are associated with acquired immune deficiency syndrome (AIDS) and may sometimes represent the initial manifestation of the illness. We described a 37-year-old human immunodeficiency virus (HIV)-infected patient with generalized choreoathetoid movements associated with AIDS. Cranial MRI revealed multiple cerebral and cerebellar abscesses. The diagnosis of toxoplasmosis was established by brain biopsy. Hemichorea and hemiballismus in AIDS patients are pathognomonic findings of cerebral toxoplasmosis. Generalized choreiform movement is a rare condition and related to the bilateral cerebral involvement in toxoplasma disease affecting the subcortical structures.
___
- 1. Tse W, Cersosimo MG, Gracies JM, Morgello S, Olanow CW, Koller W. Movement disorders and AIDS: a review. Parkinsonism Relat Disord 2004; 10: 323-34.
- 2. Cardoso F. HIV-related movement disorders: epidemiology, pathogenesis and management. CNS Drugs 2002; 16: 663-8.
- 3. Navia BA, Petito CK, Gold JW, Cho ES, Jordan BD, Price RW. Cerebral toxoplasmosis complicating the acquired immune deficiency syndrome: clinical and neuropathological findings in 27 patients. Ann Neurol 1986; 19: 224-38.
- 4. Iranzo A, Kulisevsky J, Cadafalch J, Serrano C, Grau JM. Movement disorders and AIDS. Neurologia 1996; 11: 70-5.
- 5. Piccolo I, Causarano R, Sterzi R, Sberna M, Oreste PL, Moioli C et al. Chorea in patients with AIDS. Acta Neurol Scand 1999; 100: 332-6.
- 6. Sanchez-Ramos JR, Factor SA, Weiner WJ, Marquez J. Hemichorea-hemiballismus associated with acquired immune deficiency syndrome and cerebral toxoplasmosis. Mov Disord 1989; 4: 266-73.
- 7. Pardo J, Marcos A, Bhathal H, Castro M, Varea de Seijas E. Chorea as a form of presentation of human immunodeficiency virus-associated dementia-complex. Neurology 1998; 50: 568-9.
- 8. Nath A, Hobson DE, Russell A. Movement disorders with cerebral toxoplasmosis and AIDS. Mov Disord 1993; 8: 107-12.
- 9. Maggi P, de Mari M, De Blasi R, Armenise S, Romanelli C, Andreula C et al. Choreoathetosis in acquired immune deficiency syndrome patients with cerebral toxoplasmosis. Mov Disord 1996; 1: 434-6.
- 10. Gallo BV, Shulman LM, Weiner WJ, Petito CK, Berger JR. HIV encephalitis presenting with severe generalized chorea. Neurology 1996; 46: 1163-5