Nicolas Kaiser, Matthias C Borutta, Martin Regensburger, Larissa Herbst, Lena Rühl, Timo Seitz, Stefan Gerner, Mario Schiffer, Carsten Willam, Kosmas Macha, Karl Bihlmaier
Postpump chorea is a rare hyperkinetic movement disorder following cardiac surgery with cardiopulmonary bypass. Although initially described in pediatric patients, postpump chorea is increasingly recognized in adults. We report the case of a 65-year-old woman who developed severe choreiform movements approximately 2 weeks after cardiac surgery. Extensive diagnostic workup including cerebrospinal fluid analysis revealed no alternative etiology. Notably, hypothermia had only been mild during cardiac surgery, and there were no characteristic basal-ganglia MRI abnormalities. Treatment with tiapride, a selective dopamine D2/D3 receptor antagonist with established antichoreic effects was followed by rapid neurological improvement and complete remission of symptoms. This is one of the first reports of tiapride in adult postpump chorea, supporting its role as a potentially useful symptomatic therapeutic option in this rare complication.