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- Title
CASE REPORT: 29-YEAR-OLD MALE WITH HEMICHOREA-HEMIBALLISMUS AS THE INITIAL MANIFESTATION OF CEREBRAL TOXOPLASMOSIS IN THE SETTING OF UNTREATED HIV.
- Authors
Arturo, Violante-Villanueva; Juan Carlos, López-Hernández; Lilia, Salas-Alvarado; Xiomara, García
- 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.
- Subjects
HIV infections; BRAIN; CO-trimoxazole; ARIPIPRAZOLE; SERODIAGNOSIS; BASAL ganglia; CLINDAMYCIN; MOVEMENT disorders; MAGNETIC resonance imaging; ANTIRETROVIRAL agents; TREATMENT effectiveness; RISK assessment; HALOPERIDOL; NEUROLOGIC manifestations of general diseases; CEREBRAL toxoplasmosis; CHOREA; ANTIMALARIALS; COMORBIDITY; RARE diseases; CLONAZEPAM; DISEASE risk factors; DISEASE complications
- Publication
Archivos de Neurociencias, 2023, Vol 28, Issue 3, p40
- ISSN
1028-5938
- Publication type
Article
- DOI
10.31157/an.v28i3.429