應用聚合酶連鎖反應診斷愛滋病併發大腦弓漿蟲病現半側跳躍舞蹈症之罕見病例

Presentation of Hemiballism-Hemichorea in an AIDS Patient with Cerebral Toxoplasmosis: Confirmed Diagnosis by a Nested Polymerase Chain Reaction

本文發表台灣第一位因後天免疫缺乏症候群（愛滋病）病患，臨床表現出半側跳躍舞蹈症之罕見臨床表徵。一位二十四歲男姓病患，臨床出現抽筋，半側跳躍舞蹈症及神智障礙。其腦部斷層攝影檢查，發現腦部之右側基底核雙側皮質下區域，有多處顯影劑邊緣增強病兆。應用聚合酶連鎖反應技術，于病患的血液及腦脊髓液，偵測出弓漿蟲之DNA。經抗生素（含azidothymidine, pyrimethamine及clindamycin）之治療，患者之臨床症狀逐漸改善。

We report the first case in Taiwan of hemiballism-hemichorea associated with acquired immune deficiency syndrome (AIDS). A 24-year-old male clinically presented with seizure, hemiballism-hemichorea, and subsequently loss of consciousness. His computed tomography (CT) of the brain revealed multiple rim-enhancing lesions on the bilateral centrum semiovale and right basal ganglion. Application of a nested polymerase chain reaction (PCR) succeeded in detecting Toxoplasma gondii deoxyribonucleic acid (DNA) in both the venous blood and cerebrospinal fluid specimens. Treatment with azidothymidine, pyrimethamine and clindamycin improved the dyskinetic movement. The present report illustrates this uncommon neurological complication in an AIDS patient with cerebral toxoplasmosis.