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Chronic generalised chorea is a physically and socially disabling symptom with few effective treatments. We present a case of long standing neurologically isolated non-progressive chorea which resolved almost completely after the introduction of aspirin therapy.
A 41 year old female presented with chronic generalised chorea since she was 10 years old. Onset had been over several weeks and was preceded by recurrent sore throats. There was no family history of neurological disease.
Since onset, the chorea had fluctuated slightly over time but had never progressed or resolved. It was slightly worse during the patient’s menstrual periods but was severely disabling during her pregnancies. Her first pregnancy ended with an intra-uterine death after 31 weeks. Her second pregnancy ended as a miscarriage after 8 weeks. A third pregnancy resulted in a son being delivered at 34 weeks. However, the chorea had become so severe during this pregnancy that the patient decided to undergo sterilisation. Between pregnancies, the chorea settled back to its previous levels.
Over the years, the following investigations were negative or normal: clotting studies, haemoglobin, white cell count, C-reactive protein, erythrocyte sedimentation rate, serum urea and electrolytes, liver function tests, creatinine kinase, lactate, protein electrophoresis, thyroid function tests, amino acid …