A case of late-onset chorea.

摘要: Background A 75-year-old woman with rheumatoid arthritis presented a 4-year history of chorea to hospital movement disorder clinic. The involuntary movements were initially mild, affecting only the right side body, but gradually worsened and became bilateral. There was no relevant family history. Medications included hormone replacement therapy (HRT), diclofenac sodium, vitamin D, folic acid, methotrexate zopiclone. On examination, bilateral choreiform seen, face limbs, more severely affected than left. Investigations Neuropsychological testing, laboratory blood DNA echocardiogram, MRI brain, brain perfusion single-photon emission computed tomography (SPECT) scanning. Diagnosis HRT-related chorea, possibly caused by predisposition secondary small-vessel ischemic disease, or subclinical childhood rheumatic fever. Management Discontinuation HRT.