Hemichorea-hemiballism associated to cryptococcal granuloma in AIDS: case report

Movement disorders are not common in acquired immunodeficiency syndrome. Hemichoreahemiballism (HC-HB) is the most common of them all, and it is usually related to opportunistic toxoplasmosis of the basal ganglia. We present a 28-year-old man, HIV positive with HC-HB caused by a right subthalamic granuloma, which did not respond to treatment for toxoplasmosis. Cryptoccococic antigen was positive in the cerebrospinal fluid and antifungic therapy led to clinical and radiologic improvement, thus the diagnosis of a granulomatous lesion by Cryptococcus neoformans was established. Current literature on HC-HB and its relationship with AIDS is subsequently reviewed.