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Acute-Onset Choreiform Movements in a Previously Healthy 4-Year-Old Patient

Cohen, Gordon J. MD, MPH*; Tekes, Aylin MD; Ngo, Thuy L. DO, MEd*

Pediatric Emergency Care:
doi: 10.1097/PEC.0000000000000032
Illustrative Cases

Abstract: We report the case of 4-year-old male with sinus venous thrombosis leading to bilateral thalamic and basal ganglia strokes presenting as generalized choreiform movements. Acute-onset chorea in the pediatric population is most commonly associated with Sydenham chorea, which is a manifestation of acute rheumatic fever. Chorea is a much less commonly noted sign of stroke, and when it occurs, it typically presents as hemichorea. Given the unlikely presentation, rapid and appropriate imaging was the key to diagnosis.

Author Information

From the *Department of Pediatrics, and †Division of Pediatric Radiology, Johns Hopkins School of Medicine, Baltimore, MD.

Disclosure: The authors declare no conflict of interest.

Reprints: Thuy L. Ngo, DO, MEd, Johns Hopkins Children’s Center, 1800 Orleans St, Suite G-1509, Baltimore, MD 21287 (e-mail:

© 2014 Lippincott Williams & Wilkins, Inc.