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Late-onset choreoathetotic syndrome following heart surgery

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Abstract

Choreoathetotic syndromes are frequently observed in children after congenital cardiopathy surgery. To report the case of an adult patient who developed a choreoathetotic syndrome after cardiac operation, probably related to a transitory hypometabolism of basal ganglia. A 52-year-old patient underwent heart surgery under circulatory arrest and deep hypothermia, for type III dissecting thoracic aorta aneurysm. Two weeks later she developed an acute choreic syndrome. The positron emission tomography using fluorodeoxyglucose (FDGC-PET) showed a bilateral hypometabolism of basal ganglia. After haloperidol administration, choreic syndrome improved and 6 months later FDGC-PET was normal. Choreoathetosis has been described as a rare complication after heart surgery. The authors suggest that this movement disorder may be related to hypothermia that can induce a reversible basal ganglia metabolic damage.

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References

  1. Cardoso F, Seppi K, Mair KJ, Wenning GK, Poewe W (2006) Seminar on choreas. Lancet Neurol 5:589–602

    Article  PubMed  Google Scholar 

  2. Curless RG, Katz DA, Perryman RA, Ferrer PL, Gelblum J, Weiner WJ (1994) Choreoathetosis after surgery for congenital heart disease. J Pediatr 124(5):737–739

    Article  CAS  PubMed  Google Scholar 

  3. Du Plessis AJ, Bellinger DC, Gauvreau K et al (2002) Neurologic outcome of choreoathetosis encephalopathy after cardiac surgery. Pediatr Neurol 27(1):9–17

    Article  PubMed  Google Scholar 

  4. Gherpelli JL, Azeka E, Riso A, Atik E, Ebaid M, Barbero-Marcial M (1998) Choreoathetosis after cardiac surgery with hypothermia and extracorporeal circulation. Pediatr Neurol 19(2):113–118

    Article  CAS  PubMed  Google Scholar 

  5. Medlock MD, Cruse RS, Winek SJ, Geiss DM, Horndasch RL, Schultz DL, Aldag JC (1993) A 10-year experience with postpump chorea. Ann Neurol 34(6):820–826

    Article  CAS  PubMed  Google Scholar 

  6. Jamieson SW, Auger WR, Fedullo PF, Channick RN, Kriett JM, Tarazy RY et al (1993) Experience and results with 150 pulmonary thromboendarterectomy operations over a 29-month period. J Thorac Cardiovasc Surg 106:116–126

    CAS  PubMed  Google Scholar 

  7. Ghika J (2008) Movement disorders in stroke. Rev Neurol (Paris) 164:833–836

    CAS  Google Scholar 

  8. De Bie R, Surie S, Klock JJ, Biervliet JD, De Beaumont EM, Rutten PM, Smeding HM, Bresser P, Tijssen MA (2008) Chorea in adults after endarterectomy with deep hypothermia and circulatory arrest. Ann Intern Med 149(11):842

    PubMed  Google Scholar 

  9. De Leon S, Ilbawi M, Arcilla R (1990) Choreoathetosis after deep hypothermia without circulatory arrest. Ann Thorac Surg 50:714–719

    Google Scholar 

  10. Ehle AL, Stewart RM, Lellelid NA, Leventhal NA (1984) Evoked potentials in Huntington’s disease. A comparative and longitudinal study. Arch Neurol 41(2):379–382

    CAS  PubMed  Google Scholar 

  11. Rossini PM (1998) Neurophysiology of sensorimotor integration in Parkinson disease. Clin Neurosci 5:121–130

    Article  CAS  PubMed  Google Scholar 

  12. Kuwert T, Noth J, Scholz D (1993) Comparison of somatosensory evoked potentials with striatal glucose consumption measured by positron emission tomography in the early diagnosis of Huntington’s disease. Mov Disord 8:98–106

    Article  CAS  PubMed  Google Scholar 

  13. Chu NS (1986) Sensory evoked potentials in Wilson disease. Brain 109:491–507

    Article  PubMed  Google Scholar 

  14. Margari L, Perniola T, Illiceto G, Ferrannini E, De Iaco MG, Presicci A, Santostasi R, Ventura P (2000) Familial paroxysmal exercise-induced dyskinesia and benign epilepsy: a clinical and neurophysiological study of an uncommon disorder. Neurol Sci 21:165–172

    Article  CAS  PubMed  Google Scholar 

  15. Margari L, Presicci A, Ventura P, Margari F, Perniola T (2005) Channelopathy: hypothesis of a common pathophysiologic mechanism in different forms of dyskinesia. Pediatr Neurol 32:229–235

    Article  PubMed  Google Scholar 

  16. Bachoud-Levi AC, Rémy P, Nguyen JP (2000) Motor and cognitive improvements in patients with Huntington’s disease after neural transplantation. Lancet 356:1975–1979

    Article  CAS  PubMed  Google Scholar 

  17. Busto R, Dietrich WD, Globus MY, Valdes I, Scheinberg P, Ginsberg MD (1987) Small differences intraischemic neuronal injury. J Cereb Blood Flow Metab 7:729–738

    CAS  PubMed  Google Scholar 

  18. Dietrich W, Busto R, Valdes I, Loor Y (1990) Effects of normothermic versus mild hypothermic forebrain in ischemia in rats. Stroke 21:1318–1325

    CAS  PubMed  Google Scholar 

  19. Brumberg JA, Relly EL, Doty DB (1974) Central nervous system consequences in infants of cardiac surgery using hypothermia and circulatory arrest. Circulation 50(2 Suppl):II60–II68

    Google Scholar 

  20. Kupsy WJ, Drzd MA, Barlow CF (1995) Selective injury of the globus pallidus in children with post-cardiac surge choreic syndrome. Dev Med Child Neurol 37(2):135–144

    Article  Google Scholar 

Download references

Acknowledgments

The authors thank Dr. Anna Rosati, Dr. R Soffietti, Dr. Franca Chierichetti for technical support.

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Authors and Affiliations

  1. Division of Neurology, Azienda Ospedaliera e Universitaria di Verona, Verona, Italy

    Maria Grazia Passarin, Silvia Romito, Annamaria Musso, Sarah Ottaviani, Paolo Bovi & Giuseppe Moretto

  2. Section of Rehabilitative Neurology, Department of Neurological and Visual Sciences, Azienda Ospedaliera e Universitaria di Verona, Verona, Italy

    Mirko Avesani

  3. Neuroradiology Service, Azienda Ospedaliera e Universitaria di Verona, Verona, Italy

    Franco Alessandrini

  4. Department of Cardio-surgery, Azienda Ospedaliera e Universitaria di Verona, Verona, Italy

    Giuseppe Petrilli & Francesco Santini

  5. Section of Clinical Neurology, Department of Neurological and Visual Sciences, Azienda Ospedaliera e Universitaria di Verona, Verona, Italy

    Laura Bertolasi

  6. U.O. di Neurologia, ULSS 22, Ospedale Orlandi di Bussolengo, Via Ospedale 2, 37012, Bussolengo, Verona, Italy

    Maria Grazia Passarin & Carmela Ebba Buffone

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  1. Maria Grazia Passarin
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  2. Silvia Romito
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  3. Mirko Avesani
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  6. Francesco Santini
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  7. Laura Bertolasi
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  8. Annamaria Musso
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  9. Carmela Ebba Buffone
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  10. Sarah Ottaviani
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  11. Paolo Bovi
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  12. Giuseppe Moretto
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Correspondence to Maria Grazia Passarin.

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Passarin, M.G., Romito, S., Avesani, M. et al. Late-onset choreoathetotic syndrome following heart surgery. Neurol Sci 31, 95–97 (2010). https://doi.org/10.1007/s10072-009-0171-2

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  • DOI: https://doi.org/10.1007/s10072-009-0171-2

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