A Patient with Antiphospholipid Syndrome and Psychotic Symptoms Misdiagnosed as Conversion Disorder 2

Chorea Gravidarum (CG) is a rare movement disorder characterized by rapid, irregular randomly distributed involuntary movements during pregnancy (Wild and Tabrizi 2007; Karageyim et al. 2002). The symptoms begin during the first trimester in 50% of cases, resolve spontaneously before labor in 33% of cases and in 66% post labor, but may reoccur during subsequent pregnancies. Rhabdomyolysis, hyperthermia, myoglobinuria-related disorders, and death can occur in patients with severe choreic movements (Kranick et al. 2010; Ichikawa et al. 1980). CG may accompany acute rheumatic fever, systemic lupus erythematosus, syphilis, antiphospholipid syndrome (APS), and encephalitis. Differential diagnosis should included consideration of Wilson’s and Huntington’s diseases, thyrotoxicosis, infarctions or hemorrhages of the basal ganglia, choreas related to toxins, and diabetic hyperosmolar non-ketotic comas.