LAUSR

Hemichorea-hemiballism is traditionally viewed as the result of lesions of the subthalamic nucleus (STN). However, it has also been documented with lesions involving other brain regions (ie, cortex, caudate, putamen, thalamus, and brainstem), suggesting this may be part of a wider neural network most commonly involving the posterolateral putamen. The differential diagnosis of acquired hemichorea-hemiballismus is broad, with stroke being the most common cause, however, arteriovenous malformations, cerebral trauma, hyperosmotic hyperglycemia, multiple sclerosis, and tumors have also been reported. Infections remain a possible, although uncommon, etiology, including abscesses, meningeal tuberculosis, bacterial meningitis, encephalitis, and toxoplasmosis. Here, we document the rare case of hemichorea-hemiballism as the presenting clinical sign of central nervous system tuberculosis (CNS-Tb).