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[A case of hemiballismus during cryptococcal meningitis]
1Département de Neurologie et des Maladies Infectieuses, Faculté de Médecine de l'Université d'Hacettepe, Ankara, Turquie.
Revue Neurologique
|January 1, 1990
Summary
This case report details a rare instance of hemiballismus, an involuntary movement disorder, linked to cryptococcal meningitis. Prompt treatment led to the patient's rapid recovery, resolving the hemiballismus symptoms.
Area of Science:
- Neurology
- Infectious Diseases
- Neuroimaging
Background:
- Cryptococcal meningitis is a serious fungal infection primarily affecting immunocompromised individuals.
- Hemiballismus is characterized by violent, involuntary, and random movements, typically affecting the limbs contralateral to the affected brain region.
Observation:
- A 23-year-old male presented with acute hemiballismus, confusion, fever, and neurological deficits.
- Cerebrospinal fluid analysis confirmed Cryptococcus neoformans via India ink staining.
- Brain CT revealed hyperdense lesions in the basal ganglia (caudate nucleus), internal capsule, and cerebral lobes.
Findings:
- The patient's hemiballismus was directly associated with cryptococcal meningitis.
- Cerebral lesions in the basal ganglia and internal capsule correlated with the observed motor deficits.
- Treatment with amphotericin B, 5-fluorocytosine, and haloperidol resulted in complete resolution of hemiballismus.
Implications:
- This case highlights cryptococcal meningitis as a potential cause of hemiballismus.
- Early diagnosis and appropriate antifungal and symptomatic treatment are crucial for favorable outcomes.
- The findings underscore the importance of considering infectious etiologies in movement disorders.