Differential Diagnosis for Chorea Postpartum with Visual Hallucinations

• Single most likely diagnosis
  • Chorea Gravidarum/Postpartum Chorea: This condition is a rare disorder characterized by the onset of chorea (involuntary, abrupt movements) during pregnancy or shortly after childbirth. It can be associated with psychiatric symptoms, including hallucinations, and is often linked to a history of rheumatic fever or Sydenham's chorea. The postpartum period is a time of significant hormonal and physiological change, which may precipitate or exacerbate chorea in susceptible individuals.
• Other Likely diagnoses
  • Postpartum Psychosis: While primarily a psychiatric condition, postpartum psychosis can present with a wide range of symptoms including hallucinations, delusions, and disorganized thinking. Movement disorders, including chorea, can occasionally be part of the presentation, especially in the context of severe psychiatric disturbance.
  • Systemic Lupus Erythematosus (SLE) Flare: SLE is an autoimmune disease that can affect multiple systems in the body, including the nervous system. It is known to cause a variety of neurological symptoms, including chorea and psychiatric manifestations such as hallucinations. The postpartum period can be a time of increased disease activity for women with SLE.
• Do Not Miss diagnoses
  • Cerebral Vasculitis: This condition involves inflammation of the blood vessels in the brain and can present with a wide range of neurological symptoms, including movement disorders and psychiatric symptoms. It is crucial to diagnose and treat promptly to prevent serious complications.
  • Meningoencephalitis: Infection or inflammation of the brain and meninges can cause a variety of symptoms, including hallucinations and movement disorders. This condition requires urgent diagnosis and treatment to prevent severe outcomes.
• Rare diagnoses
  • Wilson's Disease: A genetic disorder that leads to copper accumulation in the body, particularly in the liver, brain, and other organs. It can cause neurological symptoms, including movement disorders, psychiatric symptoms, and occasionally hallucinations. Although rare, it's an important consideration in young individuals presenting with these symptoms.
  • Antiphospholipid Syndrome (APS): An autoimmune disorder that can cause blood clots in arteries and veins, leading to a variety of clinical presentations, including neurological symptoms such as chorea and psychiatric manifestations. It is a rare but important consideration, especially in patients with a history of recurrent miscarriages or thrombotic events.