Patience is the key: Contraceptive induced chorea in a girl with Down Syndrome

Abstract Isolated (sub)acute chorea in young patients is a relatively rare movement disorder with a broad differential diagnosis, including drug-induced, post-infectious, auto-immunological and vascular aetiologies. We describe an adolescent girl with Down’s syndrome presenting with chorea due to or...

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Bibliographic Details
Published in:European journal of paediatric neurology 2016-07, Vol.20 (4), p.671-673
Main Authors: Eggink, Hendriekje, Kuiper, Anouk, Delnooz, Cathérine C.S, Sival, Deborah A, de Koning, Tom J, Tijssen, Marina AJ., MD PhD
Format: Article
Language:English
Subjects:
Autoimmune Diseases - diagnosis
Chorea
Chorea - chemically induced
Chorea - diagnosis
Contraceptives, Oral - adverse effects
Diagnosis, Differential
Down Syndrome
Down Syndrome - complications
Female
Humans
Menstruation Disturbances - complications
Menstruation Disturbances - drug therapy
Neurology
Oral contraceptives
Pediatrics
Young Adult
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Summary:Abstract Isolated (sub)acute chorea in young patients is a relatively rare movement disorder with a broad differential diagnosis, including drug-induced, post-infectious, auto-immunological and vascular aetiologies. We describe an adolescent girl with Down’s syndrome presenting with chorea due to oral contraceptive usage. After discontinuation of the oral contraceptive it took several months before the symptoms disappeared. Although generally well recognised, it is important to realise this delayed effect. Rejecting the diagnosis too soon may lead to unnecessary treatment for other possible underlying aetiologies, especially in patients with Down syndrome, known to be vulnerable for autoimmune disorders. We plead for discontinuation for at least three months before exclusion of oral contraceptives as cause of chorea.
ISSN:1090-3798
1532-2130
DOI:10.1016/j.ejpn.2016.03.004