[Pseudoballism secondary to spinal trauma].
A Giménez-Muñoz1, R Alarcia, L Ledesma
1Servicio de Neurología, Hospital Universitario Miguel Servet, Saragossa, Spain. alvaro.gimenezm@gmail.com
Neurologia (Barcelona, Spain)
|February 6, 2008
Summary
A rare case of cervical trauma caused ballistic movements, later evolving into choreoathetoid and dystonic movements due to spinal proprioceptive pathway injury. This study introduces the term pseudoballism.
Area of Science:
- Neurology
- Movement Disorders
- Spinal Cord Injury
Background:
- Ballism is a rare movement disorder characterized by violent, wide-amplitude flinging movements.
- It is typically associated with lesions in the contralateral subthalamic nucleus.
Observation:
- A 50-year-old male presented with ballistic movements following cervical trauma.
- He later developed choreoathetoid movements and dystonia in the left upper limb.
- Examination revealed a C2-C3 sensory level and proprioceptive loss.
Findings:
- Cervical MRI showed a transverse linear spinal lesion at the C1 level.
- This lesion impacted the spinal proprioceptive pathways.
- The patient exhibited a spectrum of movement disorders including ballistic, choreoathetoid, and dystonic movements.
Implications:
- This case highlights the diverse movement abnormalities secondary to spinal proprioceptive pathway injury.
- Associated choreoathetoid movements with proprioception loss are termed pseudochoreoathetosis.
- The term pseudoballism is proposed for acute ballistic movements in this context.
Related Concept Videos
01:25Secondary Spinal Cord Injury llI: Pathophysiology
Early Ischemia and Ionic ImbalanceWithin minutes of spinal cord injury, a secondary cascade begins, progressing over hours to weeks. Vascular damage reduces blood flow, causing ischemia and mitochondrial dysfunction. ATP depletion leads to ion pump failure, membrane depolarization, sodium influx, potassium efflux, and water accumulation, resulting in cellular swelling. Increased intracellular calcium further disrupts mitochondria and accelerates cellular injury.Excitotoxicity and Neuronal...
01:14Spinal Cord Injury ll: Pathophysiology
Spinal cord injury progresses through two interconnected phases: primary injury and secondary injury.Primary InjuryPrimary injury happens at the moment of trauma and involves immediate mechanical damage to the spinal cord.Compression happens when broken vertebrae, herniated discs, or accumulating blood (such as a hematoma) press directly against the spinal cord, distorting its normal shape and function. In cases of contusion, the cord is bruised by a blunt force (like penetrating injuries or...
01:29Herniated Intervertebral Disc l: Introduction
Intervertebral disc herniation refers to the displacement of the nucleus pulposus (the gel-like inner core of the disc) through a tear or weakened area in the annulus fibrosus (the outer fibrous ring). The displaced disc material extends beyond the normal boundaries of the disc space and may compress or irritate nearby spinal nerve roots or, less commonly, the spinal cord.Etiology and Risk FactorsHerniation commonly results from degeneration, in which aging reduces disc hydration and...