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Uncommon Movement Disorders in Chronic Hepatic Disease with Response to Rifaximin

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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.

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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 (N Y). 2019;9:10.7916/tohm.v0.649. Published 2019 Aug 2. doi:10.7916/tohm.v0.649

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