Sousa, Ana LSalgado, PaulaAlves, José ESilva, SaraFerreira, SofiaMagalhães, Marina2020-08-272020-08-272019Sousa 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.v0.6492160-8288http://hdl.handle.net/10400.16/2450Background: 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.engHepatic diseaseballismfreezingrifaximinjournal article10.7916/tohm.v0.649