Hostname: page-component-848d4c4894-4rdrl Total loading time: 0 Render date: 2024-06-23T11:21:08.705Z Has data issue: false hasContentIssue false
  • English
  • Français

Cardioembolic Caudate Infarction as a Cause of Hemichorea in Lupus Anticoagulant Syndrome

Published online by Cambridge University Press:  18 September 2015

Andrew Kirk  and
Sheila Rutledge Harding
Andrew Kirk*
Affiliation:
Divisions of Neurology (A.K.) and Hematology (S.R.H.) of the Department of Medicine, University of Saskatchewan, Saskatoon
Sheila Rutledge Harding
Affiliation:
Divisions of Neurology (A.K.) and Hematology (S.R.H.) of the Department of Medicine, University of Saskatchewan, Saskatoon
*
Department of Medicine, Division of Neurology, Royal University Hospital, Saskatoon, Saskatchewan, Canada S7N 0X0
Rights & Permissions [Opens in a new window]

Abstract:

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

An association exists between antiphospholipid antibodies and chorea. As these antibodies are associated with thrombosis, it has been suggested that cerebral infarction might cause chorea. However, CT and MRI typically do not demonstrate focal basal ganglionic lesions in such patients and an autoimmune mechanism for chorea has also been proposed. We report a young woman with left hemichorea and dyspnea. She was found to have lupus anticoagulant, large aortic and tricuspid vegetations, and pulmonary emboli. CT and MRI showed a small lesion in the head of the right caudate. In the presence of a definite cardiac source for emboli (valvular vegetations) with embolic activity (pulmonary emboli), it is likely that this patient's hemichorea was caused by cardioembolic caudate infarction.

Type
Research Article
Information
Canadian Journal of Neurological Sciences , Volume 20 , Issue 2 , May 1993 , pp. 162 - 164
Copyright
Copyright © Canadian Neurological Sciences Federation 1993

References

1.Boey, ML, Colaco, CB, Gharavi, AE, et al.Thrombosis in SLE: striking association with the presence of circulating ‘lupus’ anticoagulant. Br Med J 1983; 287: 1021–1023.CrossRefGoogle Scholar
2.Gastineau, DA, Kazmier, FJ, Nichols, WL, et al.Lupus anticoagulant: an analysis of the clinical and laboratory features of 219 cases. Am J Hematol 1985; 19: 265–275.CrossRefGoogle ScholarPubMed
3.Hughes, GRV. Thrombosis, abortion, cerebral disease and the lupus anticoagulant. Br Med J 1983; 287: 1088–1089.CrossRefGoogle ScholarPubMed
4.Briley, DP, Coull, BM, Goodnight, SH Jr.Neurological disease associated with antiphospholipid antibodies. Ann Neurol 1989; 25: 221–227.CrossRefGoogle ScholarPubMed
5.Harris, EN, Gharavi, AE, Asherson, RA, et al.Cerebral infarction in systemic lupus: association with anticardiolipin antibodies. Clin Exp Rheumatol 1984; 2: 47–51.Google ScholarPubMed
6.Levine, SR, Welch, KMA. Cerebrovascular ischemia associated with lupus anticoagulant. Stroke 1987; 18: 257–263.CrossRefGoogle ScholarPubMed
7.Asherson, RA, Khamashta, MA, Gil, A, et al.Cerebrovascular disease and antiphospholipid antibodies in systemic lupus erythematosus, lupus-like disease, and the primary antiphospholipid syndrome. Am J Med 1989; 86: 391–399.CrossRefGoogle ScholarPubMed
8.Hogan, MJ, Brunet, DG, Ford, PM, Lillicrap, D. Lupus anticoagulant, antiphospholipid antibodies and migraine. Can J Neurol Sei 1988; 15:420–425.CrossRefGoogle ScholarPubMed
9.Ford, PM, Ford, SE, Lillicrap, DP. Association of lupus anticoagulant with severe valvular heart disease in systemic lupus erythematosus. J Rheumatol 1988; 15: 597–600.Google ScholarPubMed
10.Asherson, RA, Lübbe, WF. Cerebral and valve lesions in SLE: association with antiphospholipid antibodies. J Rheumatol 1988; 15: 539–543.Google ScholarPubMed
11.Asherson, RA, Derksen, RHWM, Harris, EN. Chorea in systemic lupus erythematosus and “lupus-like” disease: association with antiphospholipid antibodies. Semin Arthr Rheum 1987; 16: 253–259.CrossRefGoogle ScholarPubMed
12.Bruyn, GW, Padberg, G. Chorea and systemic lupus erythematosus — a critical review. Eur Neurol 1984; 23: 435–448.CrossRefGoogle ScholarPubMed
13.Gutrecht, JA, Kattwinkel, N, Stillman, MJ. Retinal migraine, chorea, and retinal artery thrombosis in a patient with primary antiphospholipid antibody syndrome. J Neurol 1991; 238: 55–56.CrossRefGoogle Scholar
14.McCune, WJ, Golbus, J. Neuropsychiatric lupus. Rheum Dis Clin N Am 1988; 14: 149–167.CrossRefGoogle ScholarPubMed
15.Levine, SR, Welch, KMA. The spectrum of neurologic disease associated with antiphospholipid antibodies - lupus anticoagulant and anticardiolipin antibodies. Arch Neurol 1987; 44: 876–883.CrossRefGoogle ScholarPubMed
16.Bresnihan, B. CNS lupus. Clin Rheum Dis 1982; 183–195.CrossRefGoogle Scholar
17.Antolin, J, Amerigo, MJ, Gomez, E, et al.Chorea and systemic lupus erythematosus. Rev Clin Esp 1990; 187: 346–347.Google ScholarPubMed
18.Brandt, JT, Triplett, DA, Musgrave, K, Orr, C. The sensitivity of different coagulation reagents to the presence of lupus anticoagulants. Arch Pathol Lab Med 1987; 111: 120–124.Google Scholar
19.Triplett, DA, Brandt, JT, Kaczor, D, Schaeffer, J. Laboratory diagnosis of lupus inhibitors: a comparison of the tissue thromboplastin inhibitor, procedure with a new platelet neutralization procedure. Am J Clin Pathol 1983; 79: 678–682.CrossRefGoogle ScholarPubMed
20.Lowney, SP, Gilbert, JJ. Hemichorea and hemiballismus: recent concepts. Clin Neuropathol 1990; 9: 46–50.Google Scholar
21.Mohr, JP. Clinical syndromes of middle cerebral territory infarction. In: Barnett, HJM, Mohr, JP, Stein, BM, Yatsu, FM, eds. Stroke: Pathophysiology, Diagnosis, and Management. New York: Churchill Livingstone 1986; 401.Google Scholar
22.Davison, C, Goodhart, SP. Monochorea and somatotopic localization. Arch Neurol Psychiatry 1940; 43: 792–803.CrossRefGoogle Scholar
23.Medley, RK. Chorea and bacterial endocarditis. Br Med J 1963; 1: 861–862.CrossRefGoogle ScholarPubMed
24.Young, SM, Fisher, M, Sigsbee, A, Errichetti, A. Cardiogenic brain embolism and lupus anticoagulant. Ann Neurol 1989; 26: 390–392.CrossRefGoogle ScholarPubMed
25.Anderson, D, Bell, D, Lodge, R, Grant, E. Recurrent cerebral ischemia and mitral valve vegetation in a patient with antiphospholipid antibodies. J Rheumatol 1987; 14: 839–841.Google Scholar
26.D'Alton, JG, Preston, DN, Bormanis, J, et al.Multiple transient ischemic attacks, lupus anticoagulant and verrucous endocarditis. Stroke 1985; 16: 512–514.CrossRefGoogle ScholarPubMed