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BMJ Case Reports 2018; doi:10.1136/bcr-2017-223867
  • Unusual presentation of more common disease/injury
  • CASE REPORT

Sudden hemichorea and frontal lobe syndrome: a rare presentation of unbalanced polycythaemia vera

  1. Valentín Mateos
  1. Department of Neurology, Centro Medico de Asturias, Oviedo, Asturias, Spain
  1. Correspondence to Carmen García-Cabo, c.garciacabo{at}gmail.com
  • Accepted 2 May 2018
  • Published 14 May 2018

Summary

Polycythaemia vera (PV) is an haematological neoplasm that frequently presents neurological symptoms. However, chorea is a rare complication of this disease, occurring in less than 5% of the patients. Cognitive impairment related to PV unbalanced is also a rare complication, and it can improve with proper treatment. We present a 96-year-old-man with acute-onset hemichorea and frontal lobe syndrome with no vascular pathology in the basal ganglia or frontal region. A clear relationship was observed between the onset of involuntary movements and the cognitive impairment and worsening of haematological parameters in the patient. After causal and symptomatic treatment, the patient’s clinical status improved. In the elderly, PV must be considered as a cause of acute chorea and sudden cognitive impairment, as early diagnosis leads to effective treatment and prevention of complications.

Footnotes

  • Contributors CG-C: conception or design of the work, data collection, data analysis and interpretation, drafting the article. JF-D: critical revision of the article. VM: final approval of the version to be published.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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