uncommon movement disorders in chronic hepatic disease with response to rifaximin

• DOI: 10.7916/d8-ykf6-bp10
• Publication Date: 2019-08-02
• Authors: Sousa, Ana L.; Salgado, Paula; Alves, José E.; Silva, Sara; Ferreira, Sofia; Magalhães, Marina
• Keywords: ballism; Gait disorders; Diseases of the musculoskeletal system; Case Reports; freezing; 3. Good health; rifaximin; RC925-935; Liver--Diseases; Neurology; Chorea; Hepatic disease; Antibiotics--Therapeutic use; Neurology. Diseases of the nervous system; RC346-429

Tremor and Other Hyperkinetic Movements, Tremor and Other Hyperkinetic Movements<br/>Background: Chronic hepatic disease can present with extrapyramidal symptoms. We describe two cases that presented with highly unusual movement disorders: ballism and gait freezing. Case report: Patient 1 is a 42-year-old man with previous episodes of hepatic encephalopathy (HE) who presented with upper limb dystonia and generalized chorea that progressed to ballism. Patient 2 is a 55-year-old woman who presented with pronounced gait freezing. In both patients, features of HE and acquired hepatocerebral degeneration coexisted. They improved markedly, though transiently, with rifaximin. Discussion: Ammonia-reducing treatments should be considered in patients presenting with movement disorders due to chronic liver disease. Keywords: Hepatic disease, ballism, freezing, rifaximin Citation: Sousa AL, Salgado P, Alves JE, Silva S, Ferreira S, Magalhães M. Uncommon movement disorders in chronic hepatic disease with response to rifaximin. Tremor Other Hyperkinet Mov. 2019: 9. doi: 10.7916/tohm.v0.649.<br/>