Ballistic movements of the arm in systemic lupus erythematosis

The case of a 24-year old woman with systemic lupus erythematosis and central nervous system disease manifested by ballistic movements of the left arm is presented. She also had bilateral cerebral infarcts with pseudobulbar palsy. Ballismus is not generally known to be a manifestation of systemic lupus although there have been been reports of chorea in this disease which has responded to treatment with corticosteroids. In the present case, the ballismus disappeared when very large doses of steroids were given. This suggests that massive doses of corticosteroids may be needed for effective treatment of central nervous system lupus.