Hemichorea in tuberculous meningitis

We report on a 14 y/o HIV-negative girl with diagnosis of miliary tuberculosis (meningitis and pulmonary disease) who presented with right hemichorea three weeks after initiation of prednisone, rifampin, isoniazide, pyrazinamide and ethambutol. Brain MRI showed ischemic lesions in left caudate and l...

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Bibliographic Details
Published in:Arquivos de neuro-psiquiatria 2014-03, Vol.72 (3), p.254-254
Main Authors: Pinto, Marcus Vinicius, Aguiar, Tiago, Nogueira, Renata, Dias, Ana Carolina, Rosso, Ana Lúcia
Format: Article
Language:English
Subjects:
Adolescent
Chorea - diagnosis
Chorea - etiology
Diagnosis, Differential
Female
Human immunodeficiency virus
Humans
Magnetic Resonance Imaging
Mycobacterium
Tuberculosis, Meningeal - complications
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Summary:We report on a 14 y/o HIV-negative girl with diagnosis of miliary tuberculosis (meningitis and pulmonary disease) who presented with right hemichorea three weeks after initiation of prednisone, rifampin, isoniazide, pyrazinamide and ethambutol. Brain MRI showed ischemic lesions in left caudate and lenticulo-capsular area (Figure). Hemichorea is a rare neurological manifestation of tuberculosis[1] Basal ganglia infarcts caused by vasculitis probably decreased the GABAergic transmission in indirect basal ganglion pathway causing hemichorea. The major differential diagnoses in acquired hemichorea are Sydenham's chorea, nonketotic hyperglycemia and cerebral toxoplasmosis[2].
ISSN:0004-282X
1678-4227
1678-4227
0004-282X
DOI:10.1590/0004-282X20130230