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[Hemichorea-hemiballismus and toxoplasmosis in AIDS]
J L Gastaut1, F Nicoli, H Somma-Mauvais
1Service de Neurologie, Hôpital Ste-Marguerite, Marseille.
Abstract:
The authors report two cases of hemichorea-hemiballism revealing a toxoplasmic abscess in the subthalamic nucleus during AIDS. Despite the great frequency of this opportunistic infection such cases are exceptional. This rarity seems to be explained by the frequent association of other lesions of the basal ganglia which may prevent the movement disorders. Nevertheless an hemichorea-hemiballism in young people must suggest a cerebral toxoplasmosis. Finally a symptomatic treatment is often necessary; in these cases the use of sodium valproate must be considered, this drug being able to induce a clinical improvement.
Insights
Two AIDS patients with hemichorea-hemiballism had toxoplasmic abscesses in the subthalamic nucleus. This rare presentation suggests cerebral toxoplasmosis in young individuals, with sodium valproate showing potential clinical improvement.
Area of Science:
- Neurology
- Infectious Diseases
- Oncology
Background:
- Toxoplasmic abscesses are common opportunistic infections in AIDS patients.
- Movement disorders like hemichorea-hemiballism are rare presentations of cerebral toxoplasmosis.
Observation:
- Two cases of hemichorea-hemiballism were observed in patients with AIDS.
- The movement disorder was linked to a toxoplasmic abscess in the subthalamic nucleus.
Findings:
- The rarity of these cases may be due to concurrent basal ganglia lesions mitigating movement disorders.
- Cerebral toxoplasmosis should be considered in young individuals presenting with hemichorea-hemiballism.
Implications:
- Early diagnosis of cerebral toxoplasmosis is crucial in AIDS patients presenting with movement abnormalities.
- Sodium valproate may be a beneficial symptomatic treatment for movement disorders associated with cerebral toxoplasmosis.