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Hemiballismus following general anesthesia. A case report.
M Pilarczyk1, K Buraczyńska, M Sagan
1Department of Neurology, University School of Medicine, Jaczewskiego 8, 20-954 Lublin, Poland.
Summary
Hemiballismus, a movement disorder, can occur after general anesthesia due to subthalamic nucleus lesions. This case highlights its potential for recurrence and the need for ongoing management.
Area of Science:
- Neurology
- Neuroscience
- Movement Disorders
Background:
- Hemiballismus is characterized by involuntary, violent flinging movements, typically caused by contralateral subthalamic nucleus lesions.
- It is generally a self-limiting condition, resolving within 6-8 weeks.
Observation:
- A 49-year-old male presented with acute hemiballismus of the right arm and trunk following general anesthesia for a dental procedure.
- Brain MRI revealed bilateral globus pallidus ischemic lesions; EEG showed abnormal slowed activity.
- Despite treatment with haloperidol, clonazepam, and vasoactive medications, the patient experienced recurrent hemiballic movements.
Findings:
- Two years later, the patient was re-hospitalized due to increased frequency of movements.
- Follow-up MRI showed persistent lesions and a new ischemic focus in the left parietal lobe.
- Continued haloperidol treatment was administered.
Implications:
- This case suggests a potential link between general anesthesia and hemiballismus, possibly through ischemic events affecting basal ganglia structures.
- The recurrence of symptoms indicates that hemiballismus may not always be self-limiting and can require long-term management.
- Further research is warranted to explore the mechanisms and optimal treatment strategies for anesthesia-induced hemiballismus.
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