Recombinant interferon-α–induced chorea and frontal subcortical dementia: Table 1.

Owing to both its antiviral and antiproliferative properties, interferon-α (IFNα) therapy is widely used, and often for long periods of time, in oncologic, infectious, and autoimmune disorders. If many patients experience mild neurologic side effects, more severe neurotoxicity is uncommon.1 We report on choreic movements and frontal subcortical dementia associated with long-term recombinant IFNα therapy for chronic myelogenous leukemia (CML). A 68-year-old woman, with no psychiatric disorder, had been treated since 1997 with IFNα-2b (3 × 106 units/day) and hydroxyurea (50 mg/kg/day) for CML. She occasionally received low doses of metoclopramide (10 to 20 mg/day) for early stages chemotherapy-induced nausea, further discontinued for at least 18 months. No other concomitant medicine was prescribed. In December 1999, she presented with progressive personality changes and short-term memory loss. Permanent choreic movements of the four limbs respecting the head and the trunk appeared 2 months later. Neuropsychological tests showed frontal–subcortical dysfunction (table). Brain MRI only showed bilaterally widened ventricles without atrophy of the caudate nuclei. The lumbar …