Sporadic choreas: Analysis of a general hospital series

The incidence of sporadic chorea among general hospital admissions is unkno wn, and the relation of clinical manifestations and etiological factors to neuroimaging findings has been little investigated in this condition. We re viewed the 7,829 cases admitted to the neurology departments of two general hospitals over 3.25 years and identified 23 (8 male and 15 female) cases o f apparently sporadic chorea. Analysis of the records of these patients per mitted etiological classification as follows: drug-induced chorea (5 patien ts), vascular chorea (6 patients), chorea-vasculitis (1 patient), Sydenham' s chorea (1 patient), AIDS-related chorea (5 patients) and in 4 patients ne ither etiological factors nor neuroradiological alterations were found. Fin ally in 1 patient, the genetic test for Huntington's disease was positive. Thirteen patients had pathological neuroimaging findings; however, in only 3 were basal ganglia lesions considered to be the cause of the chorea. We c onclude that sporadic chorea is not rare among neurological department admi ssions (we found 2.94 cases per 1,000 admissions) and only in a minority of cases is the symptomatology attributable to gross basal ganglia lesions; H IV infection is an emerging cause of chorea.