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Hallucinations and chorea

Taisuke Kitamura, Seiji Gotoh, Hayato Takaki, Fumi Kiyuna, Sohei Yoshimura, Kenichiro Fujii
An 86-year-old woman with a one-year history of dementia was admitted to our hospital complaining of loss of appetite, hallucinations, and disturbance of consciousness. She gradually presented with chorea-like involuntary movements of the extremities. Diffusion-weighted magnetic resonance imaging (MRI) showed bilateral symmetrical hyperintense signals in the basal ganglia. The serum vitamin B12 level was below the lower detection limit of 50 pg/ml. The homocysteine level was markedly elevated at 115.8 nmol/ml...
July 28, 2016: Rinshō Shinkeigaku, Clinical Neurology
Barak Shapira, Lee Goldstein, Amikam Reshef, Alina Poperno
BACKGROUND: Sibutramine, an oral anorexiant, is often found as an adulterant in various counterfeit herbal slimming products and dietary supplements. The use of sibutramine has been associated with various cardiovascular and psychiatric symptoms. Here, we report a rare case of psychomotor disturbances, in a patient with no previously diagnosed movement disorders. CASE: A 26-year-old woman developed abnormal behavior, visual hallucinations, hyperkinesia, facial flushing, and dizziness after taking a counterfeit dietary supplement which contained undeclared sibutramine and phenolphtalein...
May 2016: Clinical Neuropharmacology
Deniz Kuzulugil, Kyle Sheldrick, Angela Wood, John Whitehall
Sydenham's chorea is a cardinal feature of rheumatic fever. It is known by its dyskinesia and susceptibility to carditis, but associated psychiatric disorder is being recognised. This has included tics and obsessive compulsive disorder, but we report hallucinations in an indigenous girl, suffering her third bout of chorea.
January 2013: Journal of Paediatrics and Child Health
Alexandre de Matos Soeiro, Maria Carolina Feres de Almeida, Tarso Augusto Duenhas Accorsi, Guilherme Sobreira Spina, Carlos Vicente Serrano, Flávio Tarasoutchi
We report on a 30-year-old female patient, with biological mitral valve prosthesis due to symptomatic mitral stenosis and a history of acute myocardial infarction and generalized tonic-clonic seizure episodes, visual hallucinations, cerebral thromboembolic events and, at present, chorea and acute carditis. The patient was diagnosed with active rheumatic fever (RF), systemic lupus erythematosus (SLE) and Antiphospholipid syndrome (APS). The combination of three unusual diagnoses in the same patient makes this a unique case, modifying patient treatment and prognosis...
February 2012: Arquivos Brasileiros de Cardiologia
Federica Provini, Sara Marconi, Marcello Amadori, Pietro Guaraldi, Giulia Pierangeli, Pietro Cortelli, Elio Lugaresi, Pasquale Montagna, Paolo Tinuper
INTRODUCTION: Morvan chorea is an antibody-mediated limbic encephalopathy characterized by severe insomnia, mental confusion, hallucinations, enacted dreams, hyperhidrosis, and neuromyotonia. CASE DESCRIPTION: In a 78 years old man presenting with progressive insomnia apathy and depression, a video-polysomnogram documented enacted dreams mimicking daily life activity (oneiric stupor). This finding led us to perform a search for serum antibodies to voltage-gated K+ channels, which was positive...
December 2011: Sleep Medicine
Jennifer A Vloet, Beate Herpertz-Dahlmann, Freya Hahn, Martin Häusler, Kristian Holtkamp
Sydenham's chorea is the most frequently acquired movement disorder in childhood and is characterized by involuntary and abrupt movement patterns. Some patients also show neuropsychiatric dysfunctions and psychiatric disorders, including anxiety, obsessive-compulsive disorders and tic disorders. In contrast, the association with psychotic symptoms has been reported very rarely up to now (n=4, two case reports, one prospective and one retrospective study). We report on a 12-year-old girl with acute paranoid hallucinatory symptoms and choreiform movements...
May 2010: Zeitschrift Für Kinder- und Jugendpsychiatrie und Psychotherapie
Jun Ariyama, Masakazu Hayashida, Keizo Shibata, Yuji Sugimoto, Hirokazu Imanishi, Yoshiyuki O-oi, Akira Kitamura
STUDY OBJECTIVE: To identify risk factors for reversible psychomotor dysfunction after prolonged sedation with isoflurane during mechanical ventilation in the intensive care unit (ICU). DESIGN: Retrospective case series. SETTING: General ICU at Tonami General Hospital. MEASUREMENTS: The records of 335 patients, aged from 10 months to 93 years, who were sedated with isoflurane for more than 12 hours, were reviewed. The presence or absence of reversible psychomotor dysfunction after weaning from mechanical ventilation during isoflurane sedation, and its type and duration, if present, were recorded...
December 2009: Journal of Clinical Anesthesia
Michele T M Hu, Richard Butterworth, Gavin Giovannoni, Andrew Church, Stephen Logsdail
Two weeks after starting the oral contraceptive pill, a 16-year-old girl developed increasingly violent chorea and an evolving psychosis with prominent hallucinations, ideas of reference, and paranoia. An erythematous skin rash subsequently developed and Sydenham's chorea (SC) was diagnosed. Following neuroleptic medication and steroids, her chorea and psychosis subsided. This case illustrates that severe psychotic features can occur in SC. It is recommended that antistreptolysin O titres and antibasal ganglia antibodies are checked early in patients with evolving movement disorders and prominent neuropsychiatric features, as the window for modifying the course of this immune-mediated disorder may be narrow...
April 2009: Clinical Medicine: Journal of the Royal College of Physicians of London
J Ghika
Bipedal locomotion and fine motility of hand and larynx of humans introduced musculoskeletal adaptations, new pyramidal, corticostriatal, corticobulbar, nigrostriatal, and cerebellar pathways and expansions of prefrontal, cingular, parieto-temporal and occipital cortices with derived new brain capabilities. All selectively degenerate in aged homo sapiens following 16 syndromic presentations: (1) Parkinsonism: nigrostriatal control for fast automatic movements of hand, larynx, bipedal posture and gait ("simian gait and hand")...
November 2008: Medical Hypotheses
Isabelle Arnulf, Jørgen Nielsen, Ebba Lohmann, Johannes Schiefer, Johannes Schieffer, Edward Wild, Poul Jennum, Eric Konofal, Matthew Walker, Delphine Oudiette, Sarah Tabrizi, Alexandra Durr
BACKGROUND: Sleep disorders including insomnia, movements during sleep, and daytime sleepiness are common but poorly studied in Huntington disease (HD). OBJECTIVE: To evaluate the HD sleep-wake phenotype (including abnormal motor activity during sleep) in patients with various HD stages and the length of CAG repeats. Because a mild hypocretin deficiency has been found in the brains of some patients with HD (hereinafter referred to as HD patients), we also tested the HD patients for narcolepsy...
April 2008: Archives of Neurology
J Sivet, B de la Gastine, B Mosquet, P Lescure, J Boutemy, R Le Boisselier, A Coquerel
Trimetazidine is known to induce parkinsonism but choreiform disorders have not yet been described with this drug. A 88-year-old patient treated with trimetazidine developed choreiform movements, gait disorders, tremor and visual hallucinations. These symptoms disappeared after drug withdrawal. Although this drug contains a piperazinic ring like other anti-dopaminergic drugs which are already known to potentially induce chorea like neuroleptics and some anti-convulsive drugs. When a patient treated with trimetazidine develops or worsens motor disorders (parkinsonism or choreiform disorders), this drug must be stopped...
June 2008: La Revue de Médecine Interne
M Huber, E Kirchler, M Karner, R Pycha
Delusional parasitosis (DP) is a psychotic condition in which a person has the unshakeable and mistaken belief (delusion) and/or aberrant perception (hallucination) of being infested with parasites. The disorder will be usually classified in a primary DP-group without a detectable cause (so-called pure forms), while secondary DP-groups are associated with general organic conditions, psychiatric illnesses and drugs (substance induced). Etiology and pathophysiology of DP remain however unknown. In the present paper we hypothesize for the first time a decreased striatal dopamine transporter (DAT)-functioning (corresponding with an increased extracellular dopamine-level) as etiologic condition for DP (primary and secondary groups)...
2007: Medical Hypotheses
Antônio Lúcio Teixeira, Débora Palma Maia, Francisco Cardoso
Sydenham's chorea (SC) is characterized by motor, mainly choreic involuntary movements, and psychiatric symptoms, including anxiety, depression, obsessive-compulsive and attention-deficit/hyperactivity disorders. Symptoms of SC may be considered as the result of basal ganglia dysfunction determined by autoimmune mechanisms elicited by streptococcal infection. We report on a case of a 13-year-old boy with brief psychotic episode following acute SC. His hallucinations and delusions remitted after treatment with risperidone, paralleling motor improvement...
February 2007: European Child & Adolescent Psychiatry
Bernardo Barahona Corrêa, Miguel Xavier, João Guimarães
BACKGROUND: Huntington's disease (HD) is a dominantly inherited, neurodegenerative disorder due to expansion of a polymorphic trinucleotide repeat in the short arm of chromosome 4. Clinical manifestations consist of a triad of choreic movements, cognitive decline and psychiatric syndromes starting in the fourth to fifth decade. Psychiatric manifestations vary and may precede motor and cognitive changes. Personality changes and depression occur most commonly. Paranoid schizophrenia-like symptoms occur in 6% to 25% of cases...
February 15, 2006: Clinical Practice and Epidemiology in Mental Health: CP & EMH
Abdullah Al-Asmi, An C Jansen, AmanPreet Badhwar, François Dubeau, Donatella Tampieri, Chaim Shustik, Suha Mercho, Ghislaine Savard, Carol Dobson-Stone, Anthony P Monaco, Frederick Andermann, Eva Andermann
PURPOSE: Choreoacanthocytosis (ChAc) is an autosomal recessive disorder caused by mutations in VPS13A on chromosome 9q21 and characterized by neurodegeneration and red cell acanthocytosis. Seizures are not uncommon in ChAc but have not been well characterized in the literature. We report two ChAc families in which patients presented with temporal lobe epilepsy. METHODS: Detailed medical and family histories were obtained. EEG, video-telemetry, brain magnetic resonance imaging (MRI) with volumetric studies of amygdala and hippocampus, as well as neuropsychological testing were performed...
August 2005: Epilepsia
Giuseppe Plazzi, Pasquale Montagna, Stefano Meletti, Elio Lugaresi
We describe a polysomnographic observation of the acute phase of the alcohol withdrawal syndrome, characterized by an alteration of the sleep-wake cycle and by the absence of non-rapid eye movement sleep. An atypical transitional state between rapid eye movement sleep and wake with hallucinations and enacting-dream behaviors represented the sole sleep pattern. Analogies of alcohol withdrawal syndrome with fatal familial insomnia and Morvan's fibrillary chorea suggest a common pathophysiological mechanism in these conditions...
May 2002: Sleep Medicine
V L Wheelock, T Tempkin, K Marder, M Nance, R H Myers, H Zhao, E Kayson, C Orme, I Shoulson
OBJECTIVE: To determine whether motor, behavioral, or psychiatric symptoms in Huntington disease (HD) predict skilled nursing facility (SNF) placement. METHODS: Subjects were participants in the Huntington Study Group's Unified Huntington Disease Rating Scale Database (Rochester, NY) between January 1994 and September 1999. Specific motor, psychiatric, and behavioral variables in subjects residing at home and in SNF were analyzed using chi2 and Student's t-tests...
March 25, 2003: Neurology
Russell C Dale, Andrew J Church, Robert A H Surtees, Edward J Thompson, Gavin Giovannoni, Brian G R Neville
Paroxysmal dystonic choreoathetosis (PDC) is an episodic, non-kinesogenic, extrapyramidal movement disorder. It is postulated that PDC is an ion channel disorder. We describe a sporadic case of paroxysmal dystonic choreoathetosis occurring after streptococcal pharyngitis. The episodes were characterized by abrupt-onset dystonic posturing, choreoathetosis, visual hallucinations and behavioral disturbance. Each episode lasted between 10 minutes and 4 hours, and occurred up to 4 times per day. In between attacks, examination was normal...
July 2002: Movement Disorders: Official Journal of the Movement Disorder Society
R Liguori, A Vincent, L Clover, P Avoni, G Plazzi, P Cortelli, A Baruzzi, T Carey, P Gambetti, E Lugaresi, P Montagna
Morvan's 'fibrillary chorea' or Morvan's syndrome is characterized by neuromyotonia (NMT), pain, hyperhydrosis, weight loss, severe insomnia and hallucinations. We describe a man aged 76 years with NMT, dysautonomia, cardiac arrhythmia, lack of slow-wave sleep and abnormal rapid eye movement sleep. He had raised serum antibodies to voltage-gated K(+) channels (VGKC), oligoclonal bands in his CSF, markedly increased serum norepinephrine, increased serum cortisol and reduced levels and absent circadian rhythms of prolactin and melatonin...
December 2001: Brain: a Journal of Neurology
B Schott, C Fischer-Perroudon, M Boucher
The authors present a case of Morvan's fibrillary chorea. We compare this observation with cases in the past such as the "mal des ardents", the plague of Athens, acrodynia and the epidemic of Pont St Esprit which were all characterized clinically by pain, burning sensations, hallucinations and insomnia. Since aetiological aspects remain uncertain, the similarity in clinical observations establishes a close relationship between the "mal des ardents" and the clinical features of our patient.
December 1996: Journal of the History of the Neurosciences
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