Rinsho Shinkeigaku (Clinical Neurology)

Case Report

An elderly case of moyamoya disease presenting with hemichorea

Masato Kinboshi, M.D.1), Manabu Inoue, M.D.1), Yasuhiro Kojima, M.D.1), Tomokazu Nakagawa, M.D.1), Masutaro Kanda, M.D.1) and Hiroshi Shibasaki, M.D.2)

1)Department of Neurology, Ijinkai Takeda General Hospital
2)Kyoto University Graduate School of Medicine

A 61-year-old Japanese female was admitted with sudden onset of choreic movements of the right extremities. MRI demonstrated no abnormality suggestive of acute infarcts. Cerebral angiography revealed high-grade stenosis of bilateral middle cerebral arteries at the origin and abnormal vascular network compatible with moyamoya disease. Administration of low-dose haloperidol rapidly resolved the choreic movements. SPECT obtained one month after the clinical onset demonstrated increase of the regional cerebral blood flow (rCBF) in the left basal ganglia. Moyamoya disease presenting chorea as its initial symptom was only infrequently reported in the elderly. In the present case, increased rCBF in the basal ganglia and remarkable effect of a dopamine D2 blocker suggest functional abnormality of the corresponding striatum as an underlying cause of hemichorea.
Full Text of this Article in Japanese PDF (710K)

(CLINICA NEUROL, 52: 25|29, 2012)
key words: moyamoya disease, chorea, elderly onset, rCBF, haloperidol

(Received: 31-May-11)