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Pseudochoreoathetosis. Movements associated with loss of proprioception
F R Sharp1, T A Rando, S A Greenberg
1Department of Neurology (V127), University of California, San Francisco.
Objective:
To describe seven patients with proprioceptive sensory loss and choreoathetoid movements.
Design:
Case series.
Setting:
Outpatient and inpatient university referral.
Patients:
Patients with sensory loss and abnormal movements.
Intervention:
None.
Main Outcome Measure:
None.
Results:
One patient had a parietal cortex injury, one had a thalamic infarction, two had spinal cord lesions, two had dorsal root ganglion neuronopathies, and one had an ulnar neuropathy. In each case, the duration of abnormal movements correlated with the duration of proprioceptive sensory loss, and the abnormal movements were restricted to body parts with proprioceptive sensory loss. The movements varied from chorea and athetosis to dystonia.
Conclusions:
These cases suggest that proprioceptive sensory loss can lead to a movement disorder, termed pseudochoreoathetosis, which occurs following the appearance of lesions anywhere along proprioceptive sensory pathways, from peripheral nerves to the cerebral cortex. It is hypothesized that pseudochoreoathetosis occurs because of the failure to process limb proprioceptive information in the striatum. Therefore, both choreoathetosis and pseudochoreoathetosis may be manifestations of the failure of the striatum to properly integrate cortical motor and sensory inputs.