Chorea and Parkinsonism with Elevated Striational Antibody

Area of Science:

• Neurology
• Immunology

Background:

• Subacute onset of mixed movement disorders necessitates investigation into autoimmune or paraneoplastic etiologies.
• Striational antibodies are typically linked to myasthenia gravis, with rare associations to mixed movement disorders.

Observation:

• A 90-year-old female presented with a mixed movement disorder including chorea, blepharospasm, and parkinsonism.
• She had elevated striational antibodies without evidence of malignancy.

Findings:

• The patient demonstrated a significant positive response to intravenous steroid treatment.
• This case highlights a rare presentation of striational antibody-associated autoimmune movement disorder.

Implications:

• Routine testing for striational antibodies is recommended in the work-up of autoimmune or paraneoplastic movement disorders.
• Chorea in the elderly should not be presumed to be 'senile chorea'; a treatable etiology must be sought.