Hemichorea-hemiballismus as an initial manifestation in a Moroccan patient with acquired immunodeficiency syndrome and toxoplasma infection: a case report and review of the literature

  • S Rabhi
  • K Amrani
  • M Maaroufi
  • Z Khammar
  • H Khibri
  • M Ouazzani
  • R Berrady
  • S Tizniti
  • O Messouak
  • F Belahsen
  • W Bono
Keywords: Hemichorea ballismus, acquired immunodeficiency syndrome, HIV, cerebral toxoplasmosis

Abstract

Neurologic signs and symptoms may represent the initial presentation of AIDS in 10-30% of patients. Movement disorders may be the result of direct central nervous system infection by human immunodeficiency virus (HIV) or the result of opportunistic infections. We report the case of a 59 years old woman who had hemichorea-hemiballismus subsequently found to be secondary to a cerebral toxoplasmosis infection revealing HIV infection. Movement disorders, headache and nausea were resolved after two weeks of antitoxoplasmic treatment. Brain MRI control showed a marked resolution of cerebral lesion. Occurrence of hemichorea-ballismus in patient without familial history of movement disorders suggests a diagnosis of AIDS and in particular the diagnosis of secondary cerebral toxoplasmosis. Early recognition is important since it is a treatable entity.

Key words: Hemichorea ballismus, acquired immunodeficiency syndrome, HIV, cerebral toxoplasmosis

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eISSN: 1937-8688