We report a case of paraballism in a young female, which became apparent 4 months after initiating oral contraception. When the oral contraceptive was discontinued, the paraballism decreased and was replaced by choreic movements for a period of approximately 2 weeks. The abnormal movements disappeared gradually. Only 13 cases of paraballism have been reported in medical literature, and none has been attributed to the use of oral contraceptives.
PIP: Paraballism in a 28-year old woman, associated with her 4 month intake of oral contraceptives, is described here. This constitutes only the 14th such case in the literature, and the only one in a pill user. The woman had pain in the head and neck when she first took the pill, Ovostat (1 mg lynestrenol, and 50 mcg ethinyl estradiol. Later she developed abnormal movements in the arms, neck and face. She was hospitalized in a psychiatric ward for depression, in response to the movements, and treated briefly with propanolol for palpitations. Her neurological findings were ballet-like movements of both arms, torsion movements of the neck, grimacing of the face, choreiform movements of both hands, and involuntary kicking while walking. The only other findings were an ejection murmur, and hypertrophied interventricular septum on the echocardiogram. When the pill was discontinued, the ballistic movements disappeared within days and the chorea within 2 weeks. The woman was discharged in a month with no complaints. A year later she bore her first child, with no return of abnormal movements.