A case of senile-onset progressive hemiballism and cognitive decline with diffuse brain iron accumulations

The etiologies for adults presenting with hemiballism are usually acquired lesions in the contralateral side of subthalamic nucleus. We present a 71-year-old woman with progressive onset of left hemiballism, orolingual dyskinesia and cognitive decline for 3 years. A rare genetic etiology was the final diagnosis for this index patient. In this movement disorder round, we describe our approach to this clinical presentation, and discuss the phenomenon and radiological features of this rare genetic disorder.