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Unveiling Multiple Sclerosis: Acute Hemichorea Masquerading as Sydenham's Chorea
Jayaram Saibaba1, Gopinath Karuppiah2, Amiya Ranjan Nayak2
1Junior Resident, Department of General Medicine, JIPMER, Puducherry, India, Corresponding Author.
The Journal of the Association of Physicians of India
|February 2, 2025
Summary
Multiple sclerosis (MS) can present with rare movement disorders like chorea. Early diagnosis through neuroimaging and CSF analysis is key for effective treatment and recovery.
Area of Science:
- Neurology
- Neuroimmunology
Background:
- Multiple sclerosis (MS) is a central nervous system demyelinating disorder.
- While tremors are common, rare movement disorders like chorea can occur in MS.
- Chorea and ballism are exceptionally infrequent manifestations of MS.
Purpose of the Study:
- To report a rare case of choreiform movements as an initial presentation of Multiple Sclerosis (MS).
- To highlight the importance of considering MS in young patients with acute unilateral dyskinesia when other causes are excluded.
Main Methods:
- Case report of a 20-year-old female with involuntary movements.
- Diagnostic workup included neurological examination, blood tests, cerebrospinal fluid (CSF) analysis, and Magnetic Resonance Imaging (MRI).
- Treatment involved steroids, valproate, and azathioprine.
Main Results:
- Patient presented with choreiform movements, initially suspected as Sydenham's chorea.
- Extensive workup ruled out rheumatic fever, infections, and autoimmune conditions.
- CSF analysis revealed oligoclonal bands, and MRI showed demyelinating plaques, confirming MS diagnosis.
- Significant motor function improvement was observed after 3 months of treatment.
Conclusions:
- Acute unilateral dyskinesia in young individuals warrants consideration for MS, especially after excluding common causes.
- Comprehensive neurological evaluation, including MRI and CSF analysis, is vital for diagnosing MS.
- Prompt diagnosis and management lead to significant recovery of motor functions.
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