J Korean Pediatr Soc.  1998 May;41(5):719-723.

A Case of Chorea in the Recovery Phase of Pneumococcal Meningitis

• Suh EA
• Kim DU
• Lee YK
• Choi BJ
• Kim YI
• Lee IJ

Abstract

Movement disorders (chorea, athetosis, ballism) are a rare complication that develops during the course of bacterial meningitis although associations with tuberculous meningitis are established to some extent. Movement disorders are generally believed to reflect injury to the basal ganglia, thalamus, cerebellum and cerebral cortex. Ischemic infarctions of these areas have been proposed as the cause of dyskinesias in bacterial meningitis. We experienced a case of chorea which developed in the recovery phase of pnemococcal meningitis in a 37-month-old boy. The choreic movement was initially misinterpreted as a seizure, and anticonvulsants were administered. The movement continued during the alert state in spite of anticonvulsant therapy but subsided during sleep. EEG showed severely depressed background activitiy with no epileptiform discharge. When the movement was recognized as a choreic movement, anticonvulsants were withheld and haloperidol was administered orally. The abnormal movement gradually disappeared in 3 months. But like the two other previously reported cases of postmenigitic movement disorders, this patient shows severe impairment in cognitive and motor function in the 10 months of follow up. He can only recognize some close persons and can not control the trunk and extremities well. The movement disorder which develops in the recovery phase and lasts for a long period may be associated with poor neurologic prognosis.

Keyword

Chorea; Pneumococcal meningitis

MeSH Terms

Anticonvulsants
Athetosis
Basal Ganglia
Cerebellum
Cerebral Cortex
Child, Preschool
Chorea*
Dyskinesias
Electroencephalography
Extremities
Follow-Up Studies
Haloperidol
Humans
Infarction
Male
Meningitis
Meningitis, Bacterial
Meningitis, Pneumococcal*
Movement Disorders
Prognosis
Seizures
Thalamus
Tuberculosis, Meningeal
Anticonvulsants
Haloperidol