Thirteen-Year-Old Girl Presenting Chorea after Treatment for Hyperthyroidism

Abstract

We reported a 13-year-old girl who suffered from chorea after treatment for hyperthyroidism. She was diagnosed as having hyperthyroidism in June, 1985, and treated with propylthiouracil, 250mg daily. Two months later she was considered to be euthyroid. In February, 1986, her mother noticed that she had developed restlessness and uncontrollable movements of her left hand and foot, and brought her to our hospital. The remarkable findings on neurological examination were frequent quick and jerky purposeless movement of the left proximal extremities and neck, and consistent with those of chorea. Two or three weeks after the appearance of chorea she began to experience difficulty in speaking, especially in pronouncing nasal sounds, and reading books smoothly. It took about four months for these manifestations to disappear without a special treatment except for a change of propylthiouracil for methimazole.
It is well known that chorea is a rare, initial manifestation in hyperthyroidism, but to the best of our knowledge, there has been no previous description of chorea during the euthyroid state.