{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T18:03:03Z","timestamp":1791309783669,"version":"4.3.1"},"reference-count":15,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T00:00:00Z","timestamp":1761091200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T00:00:00Z","timestamp":1761091200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disord Clin Pract"],"published-print":{"date-parts":[[2026,4]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Central nervous system fungal infections, though rare, may lead to various movement disorders either due to direct fungal invasion or as adverse effects of antifungal drugs.<\/jats:p>\n <\/jats:sec>\n \n Objectives<\/jats:title>\n This systematic review aimed to consolidate all published cases and characterize the clinical patterns, mechanisms, and outcomes.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A systematic review was conducted in line with PRISMA 2020 guidelines and registered with PROSPERO (CRD420251088348). Published case reports, series, and cohorts describing movement disorders in CNS fungal infections were identified from PubMed, EMBASE, Scopus, and Google Scholar.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Forty\u2010five studies with 50 cases were included. Movement disorders directly attributed to fungal infection (\n n<\/jats:italic>\n \u2009=\u200922; 44%) occurred predominantly in males (86.4%) with a mean age of 48\u2009years. The most common pathogens were\n Cryptococcus neoformans<\/jats:italic>\n (68.2%) and Coccidioides (13.6%). Chorea (45.5%), parkinsonism (27.3%), and tremor (13.6%) were frequent. Basal ganglia involvement was seen in 77.3% of patients. Antifungal drugs used included amphotericin B (77.3%), fluconazole (50%), and flucytosine (54.5%). Outcomes included full recovery (18.2%), partial improvement (36.4%), persistent symptoms (22.7%), and death (22.7%). Drug\u2010induced movement disorders (\n n<\/jats:italic>\n \u2009=\u200911; 22%) were linked mainly to amphotericin B (81.8%), with tremor (45.5%), myoclonus (18.2%), and dystonia (18.2%). Mortality was 45.5%. Ataxia with cerebellar involvement (\n n<\/jats:italic>\n \u2009=\u200917; 34%) presented as gait (58.8%), truncal (29.4%), or limb ataxia (17.6%), with cerebellar abscesses (52.9%) and leptomeningeal enhancement (23.5%) on imaging. Recovery occurred in 64.7%, while 17.6% died.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n CNS fungal infections can lead to diverse variety of movement disorders. Early recognition of clinical patterns and neurotoxic drug effects is essential for optimal management.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/mdc3.70403","type":"journal-article","created":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T09:28:14Z","timestamp":1761125294000},"page":"889-894","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Involuntary Movement Disorders in Central Nervous System Fungal Infections: A Systematic Review"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0044-7083","authenticated-orcid":false,"given":"Ravindra Kumar","family":"Garg","sequence":"first","affiliation":[{"name":"Department of Neurology Era's Lucknow Medical College & Hospital, Era University Lucknow India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shweta","family":"Pandey","sequence":"additional","affiliation":[{"name":"Department of Neurology King George's Medical University Lucknow India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjay","family":"Singhal","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine Dr. Ram Manohar Lohia Institute of Medical Sciences Lucknow India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0441-1489","authenticated-orcid":false,"given":"Raza Abbas","family":"Mahdi","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine Postgraduate Institute of Medical Education and Research Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,22]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1212\/CON.0000000000000241"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2021.117325"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.20789"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaclp.2021.08.010"},{"key":"e_1_2_9_6_1","article-title":"Movement disorders associated with central nervous system fungal infections: a systematic review","author":"Garg RK","year":"2025","journal-title":"PROSPERO"},{"key":"e_1_2_9_7_1","unstructured":"The Movement Disorder Society.About Movement Disorders: View clinical information resources tools and education about common movement disorders; Downloaded fromhttps:\/\/www.movementdisorders.org\/MDS\/About\/Movement-Disorder-Overviews.htm. 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