warfarin and Tourette-Syndrome

Movement disorders have only rarely been reported in association with antiphospholipid syndrome (APS). In such cases, chorea is the most common disorder observed, with occasional reports of hemidystonia, Parkinsonism, and hemiballism. We report here on 3 cases of APS (3 women ages 16, 46, and 56 years) who presented with movement disorders, including tics, tremor, myoclonus, and a corticobasal syndrome, never or rarely reported in association with this disease. Mild executive dysfunction was observed in all 3 patients. We also report the successful treatment of two of these patients with mild oral anticoagulation (INR 2-3). Movement disorders in APS seem more clinically heterogeneous than previously thought. Oral anticoagulation should be considered in the treatment of movement disorders associated with APS.

Topics: Adolescent; Antiphospholipid Syndrome; Brain; Cerebral Infarction; Diagnosis, Differential; Dyskinesias; Electroencephalography; Electromyography; Female; Follow-Up Studies; Frontal Lobe; Humans; Lupus Erythematosus, Systemic; Magnetic Resonance Imaging; Middle Aged; Movement Disorders; Myoclonus; Neurologic Examination; Neuropsychological Tests; Occipital Lobe; Phenindione; Phenprocoumon; Sneddon Syndrome; Spinocerebellar Degenerations; Tics; Tourette Syndrome; Tremor; Warfarin