# Crossed-reflex in antiphospholipid chorea

## TL;DR

A rare case of late-onset chorea in an elderly man with antiphospholipid syndrome highlights a possible link between the condition and older age.

## Contribution

This case report documents a rare crossed-reflex in APS-related chorea and suggests APS may present in older adults.

## Key findings

- A 77-year-old man with primary APS presented with subacute generalized chorea.
- The patient exhibited a left patellar crossed-reflex, a rare phenomenon in chorea cases.
- The case suggests APS may occur in late-onset chorea, challenging traditional demographic assumptions.

## Abstract

Chorea is a hyperkinetic movement disorder associated with various underlyingconditions, including autoimmune diseases such as antiphospholipid syndrome (APS). APS can manifest with a wide range of neurological symptoms, including chorea. We present a case of a 77-year-old man with subacute generalized chorea secondary to primary APS. Notably, the patient exhibited a left patellar crossed-reflex, a phenomenon rarely documented in chorea cases, the pathophysiology of which has not yet been elucidated. In summary, this case challenges the traditional demographics of antiphospholipid syndrome (APS) by suggesting a potential link between APS and late-age patients. It emphasizes the importance of considering APS in late-onset chorea cases.

The online version contains supplementary material available at 10.1007/s10072-024-07622-5.