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[Hemichorea and striatal infarction]
Revue Neurologique
|October 1, 1996
Summary
Arterial ischemic stroke in the striatum can cause hemichorea, a movement disorder. This occurs due to damage to specific neurons, but the condition is often temporary due to regulatory circuits.
Area of Science:
- Neurology
- Neuroscience
- Pathophysiology
Background:
- Hemichorea is a rare hyperkinetic movement disorder.
- Arterial ischemic stroke is a potential cause of hemichorea.
Observation:
- Two cases of hemichorea associated with contralateral striatal arterial ischemic stroke are presented.
- A review of 28 similar cases from the literature is included.
Findings:
- The pathogenesis involves GABAergic and enkephalinergic neurons in the striatal matrix projecting to the external globus pallidus.
- Damage to striatal neurons in indirect striato-thalamo-cortical pathways may disinhibit thalamic and cortical structures, causing choreiform movements.
- The rarity of this phenomenon is attributed to the distribution of enkephalinergic neurons and vascular territories.
- The transient nature of these movements is explained by regulatory circuits, including striato-nigro-striatal and cortico-striato-nigro-thalamo-cortical pathways.
Implications:
- The findings question the role of pure thalamic involvement in choreic movements.
- Understanding the pathophysiology of stroke-induced hemichorea can inform treatment strategies.
- Further research into the complex circuitry of the basal ganglia is warranted.