Reversible Hemichorea with Severe Carotid Stenosis

Area of Science:

• Neurology
• Vascular Surgery

Background:

• Hemichorea is a rare movement disorder often associated with stroke.
• This case highlights hemichorea secondary to severe carotid stenosis without infarction.

Observation:

• A 74-year-old female presented with a 6-month history of hemichorea.
• Electroencephalography and SPECT indicated hemispheric abnormality.
• Magnetic resonance imaging showed no infarction.

Findings:

• Severe carotid stenosis was identified as the cause of hemichorea.
• Carotid endarterectomy led to complete resolution of hemichorea.
• This suggests vascular stenosis can manifest as movement disorders.

Implications:

• Vascular imaging is crucial for diagnosing hemichorea when structural brain abnormalities are absent.
• Reperfusion strategies, like carotid endarterectomy, are effective treatments for hemichorea caused by stenosis.
• Increased awareness of this rare entity is vital for appropriate patient management.