Movement disorders as a complication of acute hemiplegia of childhood

We evaluate three cases of acute hemiplegia in childhood complicated by tremor and/or choreoathetosis. Each patient experienced the abrupt onset of hemiplegia thought to be localized to an insult involving the middle cerebral distribution without associated seizure, trauma, loss of consciousness or demonstrable cardiac, hematological or neoplastic causes. All three patients recovered most, if not all, strength on the affected side, but each was left with a disorder of movement involving the previously hemiplegic upper extremity. These disorders included resting and intention tremors, as well as choreoathetosis. Anticholinergic drugs failed in treating two patients, but biofeedback techniques were quite successful in one of the two patients so treated.