Chorea and contraceptives: Case report with pet study and review of the literature

Abstract

Chorea is a well-recognized but rare complication of oral contraceptive use. A 27-year-old woman developed right hemichorea while taking an oral contraceptive (OC). No other causes of chorea were found. A positron emission tomography (PET) study with (18)F-fluorodeoxyglucose demonstrated a dense focus of increased glucose metabolism involving the body of the left caudate nucleus. To our knowledge, this is the first report of a PET study in a patient with OC-induced chorea in the absence of systemic lupus erythematosus or antiphospholipid antibodies.

AHNS 2010 Research Workshop on The Biology, Prevention and Treatment of Head and Neck Cancer, October 28–30, 2010, Arlington, Virginia

“…This feature is consistent with the hypermetabolism we observed in the left cerebellar hemisphere, left dentate nucleus, and in the right red nucleus, suggesting a possible impairment of the basal ganglia and dentatorubrothalamic pathway 10. The choreoathetosis may be consistent with glucose hypermetabolism in right caudate nucleus 11…”

Oral contraceptive induced chorea: another condition associated with anti-basal ganglia antibodies: Table 1

“…16 This supports the direct involvement of basal ganglia circuits as part of the pathological process in these patients.…”

Hemiballism-hemichorea induced by ketotic hyperglycemia: case report with PET study and review of the literature

“…This change provides direct evidence that cerebral glucose metabolism in the lesion site is decreased, which supports the notion of cerebral glucose metabolic failure in the lesions. However, contralateral striatal hypermetabolism was found in FDG-PET scan of chorea caused by other conditions, like primary antiphospholipid syndrome, Contraceptives [24]. Thus, which condition reflects the true pathophysiological metabolic changes in hyperglycemia-induced HB-HC?…”