Ventral intermediate thalamotomy for hemiballismus

Stereotactic thalamotomy in an unusual case of hemiballismus is reported. This 13-year-old female developed constant left upper and lower extremity flinging movements shortly after cardiac bypass surgery for congenital heart disease at the age of 8. Numerous medications were unsuccessful in controlling these abnormal movements, hence, she stopped attending elementary school for 1 year prior to admission. Under local anesthesia, a stereotactic right ventral intermediate thalamotomy was performed to assist in making precise lesions. There was no postoperative complication. There was an immediate significant improvement. Her ballistic movements in all muscle groups disappeared from both upper and lower extremity, except for residual involuntary movements of her fingers and wrist.