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Crossed-reflex in antiphospholipid chorea.

Joan Miquel Fernández-Vidal¹, Gonzalo Olmedo-Saura^1,2,3,4, Luis Antonio Querol-Gutiérrez^1,5,6,4

¹Department of Neurology, Hospital de La Santa Creu I Sant Pau, Barcelona, Spain.

Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology

|June 19, 2024

Summary

This case study highlights antiphospholipid syndrome (APS) as a cause of late-onset chorea in a 77-year-old man. It suggests APS should be considered in elderly patients presenting with new-onset chorea.

Keywords:

Antiphospholipid syndrome Chorea Crossed-reflex

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Area of Science:

Neurology
Immunology
Movement Disorders

Background:

Antiphospholipid syndrome (APS) is an autoimmune condition linked to thrombotic events and pregnancy complications.
Neurological manifestations are common in APS, with chorea being a recognized but less frequent symptom.
This case explores chorea as a presenting neurological sign in primary APS.

Observation:

A 77-year-old male presented with subacute generalized chorea.
The patient was diagnosed with primary antiphospholipid syndrome (APS).
A rare finding of a left patellar crossed-reflex was noted, with its pathophysiology currently unknown.

Findings:

The case demonstrates a potential association between primary APS and late-onset chorea.
This presentation expands the known demographic profile of APS, suggesting it can affect older individuals.
The presence of a crossed-reflex in chorea secondary to APS is a novel observation.

Implications:

Clinicians should consider APS in the differential diagnosis of late-onset chorea, even in elderly patients.
Further research is needed to understand the pathophysiology of neurological symptoms like chorea and crossed-reflexes in APS.
This case underscores the diverse neurological spectrum of APS and its potential for late-onset presentation.