Related Experiment Videos
[Chorea as the presenting form of progressive systemic sclerosis]
M Seijo Martínez1, M Castro del Río, A Losada Campa
1Servicio de Neurología, Complexo Hospitalario de Pontevedra. mseijom@meditex.es
Neurologia (Barcelona, Spain)
|November 15, 2000
Summary
This study reports a rare case of hemichorea, a movement disorder, caused by ischemic stroke in a patient with progressive systemic sclerosis. Findings suggest primary cerebrovascular damage may be a direct complication of this condition.
Area of Science:
- Neurology
- Rheumatology
- Vascular Medicine
Background:
- Neurologic complications in progressive systemic sclerosis (PSS) are infrequent and can stem from various factors.
- Cerebrovascular disease has been occasionally reported in PSS, but its association with movement disorders remains undocumented.
Observation:
- A 66-year-old male with Raynaud's phenomenon and polyarthralgias presented with new-onset right-sided hemichorea.
- Clinical examination revealed skin changes consistent with PSS, elevated anticentromere antibody titer, and capillary abnormalities.
- Neurological imaging identified an infarct in the left caudate nucleus and internal capsule.
Findings:
- The patient's hemichorea was attributed to ischemic stroke, a previously unreported presentation of PSS.
- Brain SPECT revealed bilateral hypoperfusion, predominantly on the left side, correlating with the infarct location.
- The case supports the hypothesis that PSS can directly cause primary cerebrovascular damage.
Implications:
- This case highlights the potential for PSS to manifest with significant neurological deficits, including movement disorders.
- It underscores the importance of considering cerebrovascular complications in patients with PSS, even in the absence of typical vascular risk factors.
- Further research into the mechanisms of cerebrovascular involvement in PSS is warranted to improve patient outcomes.