Violante-Villanueva A, López-Hernández JC, Salas-Alvarado L, García X

Language: English
References: 14
Page: 40-43
PDF size: 216.23 Kb.

ABSTRACT

Background: Hemichorea and hemiballismus are rare movement disorders caused by central nervous system toxoplasmosis. Objective: To describe the case of a male patient with treatmentnaïve HIV who initiated with right hemichorea and hemiballismus. Case report: We present a 29-year-old male with a history of untreated HIV. He presented to the emergency room with rightsided hemichorea and hemiballismus. The neurological examination was unremarkable, except for the presence of abnormal movements characterized by non-rhythmic, large-amplitude, violent and occasionally choreiform movements in the right side of his body. Brain MRI revealed a ringenhancing lesion in the left basal nuclei, raising suspicion of CNS toxoplasmosis. Further serologic tests confirmed the diagnosis. Treatment was initiated with trimethoprim-sulfamethoxazole, pyrimethamine/clindamycin and antiretrovirals. Haloperidol, aripiprazole, and clonazepam were administered to alleviate abnormal movements. Subsequent MRI scans showed radiological improvement, and the patient was discharged. Conclusion: Hemichorea-hemiballismus is a neurological manifestation unfrequently related to CNS toxoplasmosis. Prompt initiation of antiretroviral therapy and antimicrobial treatment is crucial to improve patient outcomes.

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