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Drug Induced Choreas

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We're here with our 67-year-old man with atrophy

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that is parietal frontal, and to a lesser extent,

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measial temporal,

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but to a greater extent, lateral temporal,

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which is all typical of Huntington's disease,

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along with marked atrophy of the

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caudate overall volume or size.

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There's a positive involvement

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of the cerebellar hemispheres.

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And we're here to talk about about

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drug-induced chorea.

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Now, one example of a drug that requires

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a pre-existing basal ganglia problem,

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but is very shocking,

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are oral contraceptives.

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Oral contraceptives,

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there's a hundred of them that are likely to

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produce chorea in patients who have

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had previous chorea episodes.

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So, what type of episodes am I talking about?

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If they've ever had sydenham's chorea,

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chorea related to SLE,

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levodopa, in other words,

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drug induced chorea from some other medication,

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levodopa being used for Parkinson's disease

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or Parkinsonian-like syndromes,

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then those individuals are at higher risk for the

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acute onset of chorea with birth control pills.

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Typically,

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it's a buccolingual masticatory syndrome,

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characterized by repetitive movements of the

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tongue-twisting and protrusion of the tongue,

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lip smacking and chewing.

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These are the most common neuroleptic induced

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tardive dyskinesias produced by levodopa,

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but can also be produced in younger individuals

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who are at risk by birth control pills.

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Levodopa induced chorea develops in more than 40%

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of all individuals with Parkinson's disease

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who are depending on Levodopa

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as a source of treatment.

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So, this is extremely common.

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One you might not think about,

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but somebody presents with chorea as a younger patient,

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we've talked originally about HIV,

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but as a drug,

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chronic exposure to amphetamines

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and other stimulants.

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Including stimulants used to treat ADD,

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like Ritalin or Adderal

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may induce orofacial dyskinesias

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and chorea of the trunk and extremities,

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particularly those that are in the at risk category.

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Let's move on, shall we?

Report

Description

Faculty

Stephen J Pomeranz, MD

Chief Medical Officer, ProScan Imaging. Founder, MRI Online

ProScan Imaging

Tags

Vascular

Syndromes

Neuroradiology

MRI

Infectious

Drug related

Brain

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