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Hemiballism-hemichorea. Clinical and pharmacologic findings in 21 patients
1Department of Neurology, Baylor College of Medicine, Houston, Tex 77030.
Insights
In this study of 21 patients, all cases of hemiballism-hemichorea had an identifiable cause. Non-stroke causes were found in nearly half, highlighting diverse underlying medical conditions presenting as this movement disorder.
Area of Science:
- Neurology
- Movement Disorders
Background:
- Hemiballism-hemichorea is a hyperkinetic movement disorder.
- Stroke is often cited as the primary cause.
Purpose of the Study:
- To identify the causes of hemiballism-hemichorea in a patient cohort.
- To investigate the role of non-stroke etiologies.
Main Methods:
- Retrospective case series analysis of 21 patients.
- Clinical evaluation and etiological investigation.
Main Results:
- An identifiable cause was found in all 21 patients.
- Stroke was the cause in less than half of the cases (11/21).
- Other underlying medical diseases were identified in 10 of 21 patients, often presenting as hemiballism-hemichorea.
Conclusions:
- Hemiballism-hemichorea frequently presents as a symptom of underlying medical conditions.
- Pathogenesis may involve subcortical structures beyond the subthalamic nucleus.
- While the movement disorder may improve, the underlying disease poses significant risks.
Abstract:
In this series of 21 patients with hemiballism-hemichorea we found an identifiable cause in all. Unlike most other studies in which stroke was the most important cause of the movement disorder, in almost half (10 of 21) of our patients some other cause was found. Hemiballism-hemichorea was often the presenting feature of underlying medical disease. Besides the subthalamic nucleus, other subcortical structures may be involved in the pathogenesis of this hemihyperkinesia. While the movement disorder often improves spontaneously or with pharmacologic therapy, the underlying disease may result in serious consequences.