Bipolar Bozukluğu Olan Bir Hastada Hemikore ve Tardiv Diskinezi Birlikteliği

Abstract

Chorea consists of random, involuntary, continous, abrupt, short, jerky movements with different severity that can pass through one part of the body to the other parts. Hemichorea mostly occurs after the contralateral thalamic stroke, but may also occur in lesions involving the basal ganglia, white matter tracts, and the pons. Case. A 60 year old, married, primary school educated, housewife, female patient was refered to our clinic. In 1993, she had the complaints of being followed, crying, decreased self-esteem and aggression. With the diagnosis of bipolar disorder mixed episode, sertraline 50 mg/day and risperidone 4 mg/day treatment was initiated and used about 12 years for this treatment. In that time, exacerbation was not observed. In 2009, she had the complaints of tremors on the left side, involuntary movements of the arms and legs, speech disorders and balance disorders. Brain magnetic resonance imaging showed ischemia in the basal ganglia. Due to hemichorea (involuntary movements of the arms and legs), haloperidol 10 mg/day treatment was started. Nearly 4 years later, she emerged the symptoms of tardive dyskinesia.When haloperidol treatment was decreased gradually hemichorea symptoms increased whereas increasing the dose of haloperidol treatment symptoms of tardive dyskinesia increased. In this article, the difficulties in diagnosis and treatment of tardive dyskinesia and hemichorea in a bipolar patient were discussed.