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• Vol.46 No.6
• CLINICA NEUROL, 46: 415−417, 2006
• Vol.46 No.6 contents

Brief Clinical Note

Facial chorea and hemichorea due to cardiogenic cerebral embolism in the cortex and subcortical white matter

Akira Sugiura, M.D. and Masaya Fujimoto, M.D.

Department of Neurology, Iwata city general hospital
Department of Neurology, Shizuoka Institute of Epilepsy and Neurological Disorders

A 62-year-old man was admitted to our hospital because of suddenly developed bilateral facial chorea and left-sided hemichorea. He had neither hemiparesis nor sensory disturbance. Diffusion-weighted magnetic resonance images of the brain showed acute cortical and subcortical infarctions at the right insula, frontal, temporal and parietal lobes. Tiapride hydrochloride was administered for his chorea. The chorea disappeared on the next day. We diagnosed him as cardiogenic cerebral embolism because he had a paroxysmal atrial fibrillation. We supposed that his chorea was induced by interruption of excitatory output from cerebral cortex to striatum and subthalamic nucleus. Contralateral cortical and subcortical infarction must be considered when a patient suddenly develops hemichorea.

(CLINICA NEUROL, 46: 415−417, 2006)
key words: cerebral cortex, subcortical white matter, cerebral infarction, hemichorea, cardiogenic cerebral embolism

(Received: 9-Nov-05)