Acute-onset choreiform movements in a previously healthy 4-year-old patient

Area of Science:

• Neurology
• Pediatric Neurology
• Neuroimaging

Background:

• Chorea in children is often linked to Sydenham chorea, a sequela of acute rheumatic fever.
• Stroke-induced chorea is uncommon and typically presents as hemichorea.
• This case highlights a rare etiology of pediatric chorea.

Observation:

• A 4-year-old male presented with generalized choreiform movements.
• The patient was diagnosed with sinus venous thrombosis.
• The thrombosis resulted in bilateral thalamic and basal ganglia strokes.

Findings:

• Sinus venous thrombosis can manifest as generalized chorea in pediatric patients.
• This presentation is atypical compared to the usual hemichorea associated with stroke.
• Neuroimaging confirmed the diagnosis and extent of the brain injury.

Implications:

• Highlights the importance of considering stroke in pediatric patients with acute-onset chorea, even with atypical presentations.
• Emphasizes the critical role of prompt and accurate neuroimaging in diagnosing rare neurological conditions.
• Contributes to understanding the diverse clinical manifestations of sinus venous thrombosis in children.