       Document 0013
 DOCN  M9610013
 TI    [Hemichorea associated with cerebral toxoplasmosis and AIDS]
 DT    9601
 AU    Garretto NS; Bueri JA; Kremenchutzky M; Consalvo D; Segura M; Genovese
       O; Division y Catedra de Neurologia, Universidad de Buenos Aires:;
       Hospital J. M. Ramos Mejia, Argentina.
 SO    Arq Neuropsiquiatr. 1995 Mar;53(1):118-22. Unique Identifier : AIDSLINE
       MED/96035642
 AB    Only 12 AIDS cases with hemichorea were reported in the literature. We
       report the first case of hemichorea associated with AIDS and cerebral
       toxoplasmosis in our country. A 26-year-old man had 3 episodes of focal
       seizures on the left side with subsequent loss of consciousness. A few
       weeks later, he noticed progressive left-sided weakness. Examination
       revealed a left hemiparesis. MRI of the head showed a round mass in the
       right frontal lobe and a smaller lesion in the left temporo-occipital
       area. Laboratory showed positive serum ELISA and Western Blot analysis
       for HIV antibodies. Serum tests for Toxoplasma showed elevated titers.
       He was treated with pyrimethamine and sulfadiazine. His weakness
       improved and he had no further seizures. Two weeks later, choreic
       movements appeared in the left foot, finally involving the entire left
       hemibody. A second MRI showed a new small lesion in the right cerebral
       peduncle. The patient completed 6 weeks of treatment, with further
       reduction in the size of the lesions. Nevertheless, the left hemichorea
       persisted. We believe that the hemichorea our patient had was caused by
       the contralateral peduncular lesion. Lesions involving the subthalamic
       nucleus or its connections may cause contralateral hemiballismus or
       hemichorea. In spite of the favorable response to antitoxoplasmic
       therapy, the hemichorea persisted. The present report illustrates an
       uncommon neurological complication in AIDS. We believe that a
       combination of a focal cerebral lesion and the HIV infection caused the
       movement disorder presented by the patient.
 DE    Acquired Immunodeficiency Syndrome/*COMPLICATIONS  Adult  Case Report
       Chorea/*COMPLICATIONS  English Abstract  Human  Magnetic Resonance
       Imaging  Male  Toxoplasmosis, Cerebral/*COMPLICATIONS/PATHOLOGY  JOURNAL
       ARTICLE

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