HEMICHOREA IN SYSTEMIC LUPUS-ERYTHEMATOSUS - SIGNIFICANCE OF MRI FINDINGS

A young man with systemic lupus (SLE) developed hemichorea 13 years af ter the onset of his illness. For the first time in the course of his illness he had a positive test for anticardiolipin antibodies (aCL). M agnetic resonance imaging (MRI) of his brain showed lesions of presume d vascular cause in the ipsilateral basal ganglia. The findings suppor t the contention that an immune phenomenon, invisible on proton imagin g by MRI, is responsible for the striatal neuronal activation. Chorea, the clinical expression of this activation, was probably blocked on t he side previously affected by vascular pathology.