Patient 1 was a 39-year-old woman with an unremarkable medical history who developed acute involuntary right arm and leg movements. Neurologic examination revealed moderate dysarthria and subcontinuous, choreic movements in her right limbs, prevailing in the arm, which worsened during postural tasks. She occasionally had ballistic movements in her right limbs and abnormal dystonic postures. Continuous peribuccal and tongue involuntary movements were noted. Moreover, bilateral upper limb ataxia, gait and trunk ataxia, and brisk right tendon reflexes were found. There was no strength or sensory loss (video 1 at Neurology.org/cp). Brain MRI revealed a tumefactive, T2/fluid-attenuated inversion recovery (FLAIR) hyperintense, T1 hypointense contrast-enhancing demyelinating lesion in the left cerebral peduncle, extending to the substantia nigra and subthalamic nucleus (STN) (figure, A-C). Multiple hyperintense T2/FLAIR, T1 hypointense, non-contrast-enhancing demyelinating lesions in the hemispheric and periventricular deep white matter, brainstem, and cerebellar hemispheres were also found. All serologic tests were within normal limits. Isoelectric focusing (IEF) revealed 9 CSF oligoclonal bands (OCBs). A diagnosis of multiple sclerosis (MS) was made and the patient was treated with high-dose methylprednisolone with improvement of symptoms.

Acute hemichorea as unusual first multiple sclerosis presentation / Giovannini, Giada; Cavallieri, Francesco; Meletti, Stefano; Chiari, Annalisa; Mandrioli, Jessica; Ferraro, Diana; Valzania, Franco. - In: NEUROLOGY. CLINICAL PRACTICE. - ISSN 2163-0402. - 7:1(2017), pp. e9-e11. [10.1212/CPJ.0000000000000279]

Acute hemichorea as unusual first multiple sclerosis presentation

GIOVANNINI, GIADA;Cavallieri, Francesco;MELETTI, Stefano;Mandrioli, Jessica;FERRARO, Diana;
2017

Abstract

Patient 1 was a 39-year-old woman with an unremarkable medical history who developed acute involuntary right arm and leg movements. Neurologic examination revealed moderate dysarthria and subcontinuous, choreic movements in her right limbs, prevailing in the arm, which worsened during postural tasks. She occasionally had ballistic movements in her right limbs and abnormal dystonic postures. Continuous peribuccal and tongue involuntary movements were noted. Moreover, bilateral upper limb ataxia, gait and trunk ataxia, and brisk right tendon reflexes were found. There was no strength or sensory loss (video 1 at Neurology.org/cp). Brain MRI revealed a tumefactive, T2/fluid-attenuated inversion recovery (FLAIR) hyperintense, T1 hypointense contrast-enhancing demyelinating lesion in the left cerebral peduncle, extending to the substantia nigra and subthalamic nucleus (STN) (figure, A-C). Multiple hyperintense T2/FLAIR, T1 hypointense, non-contrast-enhancing demyelinating lesions in the hemispheric and periventricular deep white matter, brainstem, and cerebellar hemispheres were also found. All serologic tests were within normal limits. Isoelectric focusing (IEF) revealed 9 CSF oligoclonal bands (OCBs). A diagnosis of multiple sclerosis (MS) was made and the patient was treated with high-dose methylprednisolone with improvement of symptoms.
7
1
e9
e11
Acute hemichorea as unusual first multiple sclerosis presentation / Giovannini, Giada; Cavallieri, Francesco; Meletti, Stefano; Chiari, Annalisa; Mandrioli, Jessica; Ferraro, Diana; Valzania, Franco. - In: NEUROLOGY. CLINICAL PRACTICE. - ISSN 2163-0402. - 7:1(2017), pp. e9-e11. [10.1212/CPJ.0000000000000279]
Giovannini, Giada; Cavallieri, Francesco; Meletti, Stefano; Chiari, Annalisa; Mandrioli, Jessica; Ferraro, Diana; Valzania, Franco
File in questo prodotto:
File Dimensione Formato  
2016_NEURCLINPRACT.pdf

embargo fino al 22/07/2017

Tipologia: Versione dell'editore (versione pubblicata)
Dimensione 364.09 kB
Formato Adobe PDF
364.09 kB Adobe PDF Visualizza/Apri
Pubblicazioni consigliate

Caricamento pubblicazioni consigliate

Licenza Creative Commons
I metadati presenti in IRIS UNIMORE sono rilasciati con licenza Creative Commons CC0 1.0 Universal, mentre i file delle pubblicazioni sono rilasciati con licenza Attribuzione 4.0 Internazionale (CC BY 4.0), salvo diversa indicazione.
In caso di violazione di copyright, contattare Supporto Iris

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/1133794
Citazioni
  • ???jsp.display-item.citation.pmc??? 1
  • Scopus 1
  • ???jsp.display-item.citation.isi??? 2
social impact