Osteomalacia presenting as chorea.

Nutritional Vitamin D Deficiency Presenting as Hemichorea

“…Hypocalcemia has been described to be causative in movement disorders. [3][4][5][6][7] The limitation of the chorea to the right side of the body is consistent with the lack of contralateral cortical input to the basal ganglia as a result of the prior stroke. In this case, the cause of the patient's hemichorea was hypocalcemia secondary to nutritional vitamin D deficiency.…”

Short report: Paroxysmal choreoathetosis as a presenting symptom in idiopathic hypoparathyroidism

“…Muentner and Whisnant (1968) suggested that the same noxious process which attacks the parathyroid glands attacks the basal ganglia as well. This mechanism, however, cannot explain the occurrence of extrapyramidal syndromes in post-operative hypoparathyroidism (McKinney, 1962;Fonesca and Calverley, 1967;Muentner and Whisnant, 1968;Rubenstein and Brust, 1974) and in hypocalcaemia secondary to other causes (Hosking et al, 1975). In most of the cases, correction of the basic metabolic disturbance reverse the neurological symptoms, even in those cases where basal ganglia calcification has already occurred.…”

Hypocalcaemic chorea secondary to malabsorption

“…The peripheral neurological complication, tetany, is commonly seen whatever the cause of hypocalcaemia. However, the central neurological complication of chorea has been reported only when the hypocalcaemia was a consequence of hypoparathyroidism (Simpson, 1952;Frame, 1965;MacGregor and Whitehead, 1954), or anti-convulsant therapy (Hosking et al, 1975). The parathyroid hormone estimation, during convalescence when the patient was normocalcaemic, was normal which does not exclude hypoparathyroidism but makes it unlikely.…”

“…In that one report, the chorea followed hypocalcaemia in a case of drug-induced osteomalacia during the treatment of epilepsy (Hosking et al, 1975). However, chorea has not been reported following hypocalcaemia due to any other cause.…”