Cryptococcal Meningitis Causing Refractory Hemichorea-Hemiballismus Treated With Pallidotomy.

Cureus

Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center; and Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, USA.

Published: July 2021

We report a case of a 31-year-old immunocompetent male who presented with altered mental status and agitation requiring intubation. As sedation was weaned, he demonstrated choreiform movements with associated hemiballismus of the right upper and lower extremities, and he was ultimately diagnosed with cryptococcal meningitis. The patient's chorea did not terminate after the completion of induction antifungal therapy and all pharmacologic options for the management of chorea were ineffective. He underwent a successful unilateral pallidotomy using standard stereotactic methodology targeting the posterior-ventral pallidum, and his choreiform movements dramatically improved post-operatively within 48 hours.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8372680PMC
http://dx.doi.org/10.7759/cureus.16493DOI Listing

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