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She did not respond to immunotherapy and died shortly afterwards. This case highlights paraneoplastic striatal encephalitis as an important cause of late-onset chorea. Psychiatric symptoms may precede neurological features by several years, and red flags such as subacute progression, systemic symptoms and characteristic MR imaging changes should prompt early investigation for neuronal antibodies and malignancy.<\/jats:p>","DOI":"10.1136\/pn-2026-005176","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T17:25:36Z","timestamp":1777051536000},"page":"pn-2026-005176","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Late-onset subacute chorea"],"prefix":"10.1136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5250-8602","authenticated-orcid":false,"given":"Pedro","family":"Fraiman","sequence":"first","affiliation":[{"name":"Division of General Neurology, Ataxia and Neurorheumatology Unit, Department of Neurology and Neurosurgery, Universidade Federal de S\u00e3o Paulo, Sao Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaliny Oliveira","family":"Peixoto","sequence":"additional","affiliation":[{"name":"Division of Neurology, Hospital Universit\u00e1rio Onofre Lopes, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rodrigo","family":"Alencar e Silva","sequence":"additional","affiliation":[{"name":"Division of Neurology, Hospital Universit\u00e1rio Onofre Lopes, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cl\u00e9cio","family":"de Oliveira Godeiro Junior","sequence":"additional","affiliation":[{"name":"Division of Neurology, Hospital Universit\u00e1rio Onofre Lopes, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,4,24]]},"reference":[{"key":"2026042410252766000_pn-2026-005176v1.1","doi-asserted-by":"publisher","DOI":"10.1136\/pn.2007.134585"},{"key":"2026042410252766000_pn-2026-005176v1.2","doi-asserted-by":"publisher","DOI":"10.1097\/WCO.0b013e328347b307"},{"key":"2026042410252766000_pn-2026-005176v1.3","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1111\/j.1600-0404.1997.tb00092.x","article-title":"Senile chorea: a multicenter prospective study","volume":"95","author":"Garc\u00eda Ruiz","year":"1997","journal-title":"Acta Neurol Scand"},{"key":"2026042410252766000_pn-2026-005176v1.4","doi-asserted-by":"crossref","first-page":"1331","DOI":"10.1016\/S0140-6736(00)46849-2","article-title":"THE NEUROLOGY OF OLD AGE.*1","volume":"217","author":"Critchley","year":"1931","journal-title":"The Lancet"},{"key":"2026042410252766000_pn-2026-005176v1.5","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1016\/j.cger.2006.06.005","article-title":"Geriatric chorea","volume":"22","author":"Lorincz","year":"2006","journal-title":"Clin Geriatr Med"},{"key":"2026042410252766000_pn-2026-005176v1.6","doi-asserted-by":"crossref","unstructured":"McKeon A , Tracy J . 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