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Lupus
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Hemichorea in systemic lupus erythematosus: significance of MRI findings

F. Al Jishi

Department of Medicine (MBC 46), King Faisal Specialist Hospital and Research Centre, Box 3354, Riyadh 11211, Saudi Arabia

M.Z. Al Kawi

Department of Medicine (MBC 46), King Faisal Specialist Hospital and Research Centre, Box 3354, Riyadh 11211, Saudi Arabia

K. El Ramahi

Department of Medicine (MBC 46), King Faisal Specialist Hospital and Research Centre, Box 3354, Riyadh 11211, Saudi Arabia

S. Omer

Department of Medicine (MBC 46), King Faisal Specialist Hospital and Research Centre, Box 3354, Riyadh 11211, Saudi Arabia

A young man with systemic lupus (SLE) developed hemichorea 13 years after the onset of his illness. For the first time in the course of his illness he had a positive test for anticardiolipin antibodies (aCL). Magnetic resonance imaging (MRI) of his brain showed lesions of presumed vascular cause in the ipsilateral hasal ganglia. The findings support the contention that an immune phenomenon, invisible on proton imaging by MRI, is responsible for the striatal neuronal activation. Chorea, the clinical expression of this activation, was probably blocked on the side previously affected by vascular pathology.

Key Words: chorea • anticardiolipins • vasculitis • movement disorder

Lupus, Vol. 4, No. 4, 321-323 (1995)
DOI: 10.1177/096120339500400416
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