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Butnariu I, Antonescu-Ghelmez D, Moraru A, Anghel DN, Cojocaru FM, Tuță S, Ciobanu AM, Antonescu F. Chorea and Cognitive Impairment in JAK2V617F-Positive Myeloproliferative Disorders: A Case Report and Literature Review. MEDICINA (KAUNAS, LITHUANIA) 2023; 60:18. [PMID: 38276052 PMCID: PMC10817622 DOI: 10.3390/medicina60010018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 12/14/2023] [Accepted: 12/19/2023] [Indexed: 01/27/2024]
Abstract
Chorea is a hyperkinetic movement disorder, accompanied by dystonia, myoclonus, tics, stereotypies, and tremors. It is characterized by excessive, purposeless movements that are distressing, irregularly timed, and randomly distributed. Chorea can be present in many diseases, such as hereditary, metabolic disturbance, drug-induced, and functional disorders, and, rarely, genetic, autoimmune, and infectious diseases. Primary myelofibrosis (PMF) is a myeloproliferative neoplasm that leads to ineffective clonal hematopoiesis, fibrous tissue deposits in the bone marrow, extramedullary hematopoiesis, and splenomegaly. In rare cases, following uncertain pathological mechanisms, it can present with chorea, particularly affecting the limbs, head, and orofaciolingual muscles. We present a case of a male patient with evolving PMF over several years who was admitted for progressive cognitive impairment and generalized involuntary movement disorder. We also present a review of all cases of myeloproliferative disorders presenting with chorea published in the last 40 years.
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Affiliation(s)
- Ioana Butnariu
- Department of Clinical Neurosciences, “Carol Davila” University of Medicine and Pharmacy, 020023 Bucharest, Romania
- Neurology Department, National Institute of Neurology and Neurovascular Diseases, 041915 Bucharest, Romania
| | - Dana Antonescu-Ghelmez
- Department of Clinical Neurosciences, “Carol Davila” University of Medicine and Pharmacy, 020023 Bucharest, Romania
- Neurology Department, National Institute of Neurology and Neurovascular Diseases, 041915 Bucharest, Romania
| | - Adriana Moraru
- Neurology Department, National Institute of Neurology and Neurovascular Diseases, 041915 Bucharest, Romania
| | - Daniela Nicoleta Anghel
- Neurology Department, National Institute of Neurology and Neurovascular Diseases, 041915 Bucharest, Romania
| | | | - Sorin Tuță
- Department of Clinical Neurosciences, “Carol Davila” University of Medicine and Pharmacy, 020023 Bucharest, Romania
- Neurology Department, National Institute of Neurology and Neurovascular Diseases, 041915 Bucharest, Romania
| | - Adela Magdalena Ciobanu
- Department of Clinical Neurosciences, “Carol Davila” University of Medicine and Pharmacy, 020023 Bucharest, Romania
- “Prof. Dr. Alexandru Obregia” Clinical Psychiatry Hospital, 041914 Bucharest, Romania
| | - Florian Antonescu
- Department of Clinical Neurosciences, “Carol Davila” University of Medicine and Pharmacy, 020023 Bucharest, Romania
- Neurology Department, National Institute of Neurology and Neurovascular Diseases, 041915 Bucharest, Romania
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Ghadery CM, Kalia LV, Connolly BS. Movement disorders of the mouth: a review of the common phenomenologies. J Neurol 2022; 269:5812-5830. [PMID: 35904592 DOI: 10.1007/s00415-022-11299-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 07/16/2022] [Accepted: 07/18/2022] [Indexed: 11/26/2022]
Abstract
Movement disorders of the mouth encompass a spectrum of hyperactive movements involving the muscles of the orofacial complex. They are rare conditions and are described in the literature primarily in case reports originating from neurologists, psychiatrists, and the dental community. The focus of this review is to provide a phenomenological description of different oral motor disorders including oromandibular dystonia, orofacial dyskinesia and orolingual tremor, and to offer management strategies for optimal treatment based on the current literature. A literature search of full text studies using PubMed/Medline and Cochrane library combined with a manual search of the reference lists was conducted until June 2021. Results from this search included meta-analyses, systematic reviews, reviews, clinical studies, case series, and case reports published by neurologists, psychiatrists, dentists and oral and maxillofacial surgeons. Data garnered from these sources were used to provide an overview of most commonly encountered movement disorders of the mouth, aiding physicians in recognizing these rare conditions and in initiating appropriate therapy.
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Affiliation(s)
- C M Ghadery
- Division of Neurology, Department of Medicine, McMaster University, 237 Barton Street East, Hamilton, ON, L8L 2X2, Canada
| | - L V Kalia
- Division of Neurology, Department of Medicine, Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J Safra Program in Parkinson's Disease, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
| | - B S Connolly
- Division of Neurology, Department of Medicine, McMaster University, 237 Barton Street East, Hamilton, ON, L8L 2X2, Canada.
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Raza HK, Chansysouphanthong T, Singh S, Amir A, Raza MW, Zhang Z, Cui G, Chen H. Polycythemia vera complicated by chorea: A case report and the review of Chinese and international literature. Rev Neurol (Paris) 2021; 177:1025-1030. [PMID: 33781561 DOI: 10.1016/j.neurol.2020.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 11/21/2020] [Accepted: 11/23/2020] [Indexed: 11/19/2022]
Affiliation(s)
- H K Raza
- Department of Neurology, the Affiliated Hospital of Xuzhou Medical University, 221002 Xuzhou, China; School of International Education, Xuzhou Medical University, 221002 Xuzhou, China
| | - T Chansysouphanthong
- School of International Education, Xuzhou Medical University, 221002 Xuzhou, China
| | - S Singh
- School of International Education, Xuzhou Medical University, 221002 Xuzhou, China
| | - A Amir
- Central Park Medical College, Lahore, Pakistan
| | - M W Raza
- Hainan University, Haikou, Hainan, China
| | - Z Zhang
- Department of Neurology, the Affiliated Hospital of Xuzhou Medical University, 221002 Xuzhou, China
| | - G Cui
- Department of Neurology, the Affiliated Hospital of Xuzhou Medical University, 221002 Xuzhou, China.
| | - H Chen
- Department of Neurology, the Affiliated Hospital of Xuzhou Medical University, 221002 Xuzhou, China.
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Abstract
INTRODUCTION Chorea is defined as jerk-like movements that move randomly from one body part to another. It is due to a variety of disorders and although current symptomatic therapy is quite effective there are few etiology- or pathogenesis-targeted therapies. The aim of this review is to summarize our own experience and published evidence in the treatment of chorea. Areas covered: After evaluating current guidelines and clinical practices for chorea of all etiologies, PubMed was searched for the most recent clinical trials and reviews using the term 'chorea' cross referenced with specific drug names. Expert commentary: Inhibitors of presynaptic vesicular monoamine transporter type 2 (VMAT2) that cause striatal dopamine depletion, such as tetrabenazine, deutetrabenazine, and valbenazine, are considered the treatment of choice in patients with chorea. Some clinicians also use dopamine receptor blockers (e.g. antipsychotics) and other drugs, including anti-epileptics and anti-glutamatargics. 'Dopamine stabilizers' such as pridopidine and other experimental drugs are currently being investigated in the treatment of chorea. Deep brain stimulation is usually reserved for patients with disabling chorea despite optimal medical therapy.
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Affiliation(s)
- H Bashir
- a Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology , Baylor College of Medicine , Houston , TX , USA
| | - J Jankovic
- a Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology , Baylor College of Medicine , Houston , TX , USA
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