Chorea induced by oral contraceptives.
A rare complication of oral contraceptive therapy is the induction of chorea. We here describe five cases of chorea in patients receiving low- or high-dose estrogen-containing contraceptives. All patients were nulliparous, young (average age 19 years), and became symptomatic shortly (average of 5 weeks) after initiation of contraceptive therapy. Two patients previously suffered an episode of Syndenham chorea; one experienced chorea in the course of Henoch-Schönlein purpura; and two had a history of congenital cyanotic heart disease without chorea. Dyskinesia resolved in all patients upon discontinuing the medication. Patients with preexisting striatal abnormalities appear more susceptible to oral contraceptive-induced chorea which is reversible on drug discontinuation. The mechanism of oral contraceptive-induced chorea is unknown, but clinical and experimental data suggest that it involves altered central dopaminergic activity.
D000293:Adolescent; D000328:Adult; D002819:Chorea / Q000139:chemically induced*; D003276:Contraceptives, Oral / Q000009:adverse effects*; D003278:Contraceptives, Oral, Hormonal / Q000009:adverse effects*; D004997:Ethinyl Estradiol / Q000009:adverse effects; D005040:Ethynodiol Diacetate / Q000009:adverse effects; D005260:Female; D006801:Humans; D008656:Mestranol / Q000009:adverse effects; D009644:Norgestrel / Q000009:adverse effects
D003276:Contraceptives, Oral; D003278:Contraceptives, Oral, Hormonal; D009644:Norgestrel; D004997:Ethinyl Estradiol; D005040:Ethynodiol Diacetate; D008656:Mestranol