Amphetamine-induced hemichorea

Martínez‐Dubarbie, Francisco; Ricart-Colome, Cinta; Manzanedo-Terán, Beatriz; Infante, Jon

doi:10.1007/s10072-021-05073-w

Cited by 6 publications

(6 citation statements)

References 5 publications

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“…The most common cause of drug-induced asymmetric chorea is secondary to levodopa use in patients with idiopathic Parkinson’s disease who develop dyskinesia, however, this is outside of the scope of this review. Multiple other medications have been identified as causing an asymmetric or hemichorea including gabapentin [ 113 ], valproate [ 114 ], amphetamine [ 115 ], anti-histamine [ 116 117 ], selective serotonin reuptake inhibitors [ 118 ], neuroleptics [ 119 ] and z-drugs [ 120 ]. As previously mentioned, oral estrogen has been associated with drug-induced chorea as well, although this appears to be through a specific hormonal mechanism [ 105 106 107 108 109 ].…”

Section: Resultsmentioning

confidence: 99%

One Side of the Story; Clues to Etiology in Patients with Asymmetric Chorea

Cincotta¹,

Walker

2022

Tremor and Other Hyperkinetic Movements

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Background: Chorea can be due to a large number of etiologies. Unilateral chorea is classically related to a contralateral structural lesion, e.g. of the putamen or subthalamic nucleus, however, based upon personal impressions, we have observed that systemic disease, in particular metabolic or autoimmune conditions, can also lead to a unilateral or markedly asymmetric presentations. We sought to investigate this impression by reviewing the literature. Methods: A PubMed search was conducted using the terms asymmetric” AND “chorea” OR “hemichorea” OR “unilateral” AND “chorea” OR “monochorea” OR “right greater than left” AND “chorea” OR “left greater than right” AND “chorea” OR “right more than left” AND “chorea” OR “left more than right” AND “chorea” as well as “hemiballismus” NOT “stroke” NOT “infarct” NOT “dyskinesia. A total of 243 sources were felt to meet criteria and were reviewed. Results: The most common etiology of reported hemi- or asymmetric chorea was diabetic non-ketotic hyperglycemic hemichorea/hemiballismus. Other common diagnoses were Sydenham’s disease, antiphospholipid syndrome and drug-induced chorea. The vast majority of patients with hemi- or asymmetric chorea had acquired rather than genetic, degenerative or congenital causes. Conclusion: Despite the potential limitations of our literature review, the evidence presented here supports the observation that the vast majority of asymmetric or unilateral chorea presentations are due to acquired causes, and in this situation an exhaustive search for reversible etiology should be undertaken. However, presentation with symmetric, generalized chorea does not exclude reversible causes, and investigations should address these in addition to genetic and neurodegenerative etiologies.

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Section: Resultsmentioning

confidence: 99%

One Side of the Story; Clues to Etiology in Patients with Asymmetric Chorea

Cincotta¹,

Walker

2022

Tremor and Other Hyperkinetic Movements

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“…Methamphetamine use results in excessive dopamine levels in the brain via D1 receptors [ 2 ], secondary to lipid solubility and ability to diffuse into the brain through the blood brain barrier [ 3 ]. Methamphetamine directly increases dopamine, reduces reuptake and inhibits monoamines which leads to prolonged extracellular dopamine activity in the brain [ 4 ]. This potency and action on the central nervous system can lead to hyperkinetic effects and psychosis [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…With more severe cases benzodiazepines and antipsychotics can be useful; however, mainstay of treatment in methamphetamine-induced choreoathetosis involves symptomatic management of secondary complaints including body aches and pain secondary to spasm [ 7 ]. In a similar presentation of amphetamine-induced hemichorea, a 46-year-old female patient had subsequent left leg involvement, however in this case lab work including glucose was normal [ 4 ]. In our patient, there may be some component of methamphetamine impact on the patient’s initial presentation, improvement occurred with antipsychotics, insulin and symptom control for pain.…”

Section: Discussionmentioning

confidence: 99%

“…Hemichorea can result from pharmacological agents, in this case, both second-generation antipsychotics and methamphetamine are present and are potential contributors to our patient's presentation. In this case report, we describe a non-ketotic hyperglycemic hemichorea-hemiballismus with other potential secondary etiologies also present [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

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Non-Ketotic Hyperglycemic Hemichorea-Hemiballismus in the Setting of Antipsychotics and Methamphetamine

Nelson

Ohnoutka

Ulen

2021

Cureus

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“…99 Amphetamine, methamphetamine, 3,4-methylenedioxymethamphetamine (MDMA), and methylphenidate have also all been implicated in acute-onset chorea. 99,101 Opiates are not known to cause chorea, with the possible exception of methadone, for which there are several case reports. [102][103][104] The mechanism is not well understood, but suspected to be secondary to increased sensitivity of dopaminergic neurons in the striatum.…”

Section: Toxic Causesmentioning

confidence: 99%

Diagnostic Uncertainties: Chorea

Cincotta

Walker

2023

Semin Neurol

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Chorea is a hyperkinetic movement disorder with a multitude of potential etiologies, both acquired and inherited. Although the differential diagnosis for new-onset chorea is extensive, there are often clues in the history, exam, and basic testing that can help to narrow the options. Evaluation for treatable or reversible causes should take priority, as rapid diagnosis can lead to more favorable outcomes. While Huntington's disease is most common genetic cause of chorea, multiple phenocopies also exist and should be considered if Huntington gene testing is negative. The decision of what additional genetic testing to pursue should be based on both clinical and epidemiological factors. The following review provides an overview of the many possible etiologies as well as a practical approach for a patient presenting with new-onset chorea.

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Amphetamine-induced hemichorea

Cited by 6 publications

References 5 publications

One Side of the Story; Clues to Etiology in Patients with Asymmetric Chorea

One Side of the Story; Clues to Etiology in Patients with Asymmetric Chorea

Non-Ketotic Hyperglycemic Hemichorea-Hemiballismus in the Setting of Antipsychotics and Methamphetamine

Diagnostic Uncertainties: Chorea

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