BMJ Case Reports 2011; doi:10.1136/bcr.05.2011.4261
  • Rare disease

Bilateral ballism following streptococcal infection, associated with psychiatric disorder and purpura

  1. Carlos J Bidot2
  1. 1Department of Internal Medicine, Havana University School of Medicine, Havana, Cuba
  2. 2Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, Florida, United States
  1. Correspondence to Dr Antonio N Gomez, antoniongomez{at}


A woman in her 30s was brought to the hospital with abnormal movements. Three months prior, the patient had exacerbation of the movements after an episode of recurrent pharyngitis. Neurological examination revealed, violent involuntary movement that affected both upper and lower limbs, hypotonia and ataxia. Other findings including emotional instability and involuntary movements were considered ballistic. Throat culture showed β haemolytic streptococci, tonsillectomy and specific antibiotic improved bilateral ballism and psychiatic disorder. This is the first report of bilateral ballism poststreptococcal infection.


  • Competing interests None.

  • Patient consent Not obtained.

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