Clinical features of hemichoreahemiballism: A stroke-related movement disorder

We examined pathogenesis and clinical features of three hemichorea-hemiballism (HCHB) cases. We studied their age, magnetic resonance imaging results, vascular risk factors, management, and outcomes. One man and two women (aged 74-86 years) demonstrated acute onset of HCHB, lasting for at least several months. Patients had one or more vascular risk factors, including hypertension and diabetes. All patients presented subacute or old infarction in the basal ganglia with contralateral symptoms. We administered clonazepam (0.5-1 mg/day), haloperidol (0.375-0.75 mg/day), or both as necessary and observed symptom-control. Vascular lesions in the basal ganglia were a contributing factor. Symptoms were controlled using pharmacotherapy with gamma-aminobutyric acid-agonist (clonazepam) or anti-dopaminergic (haloperidol) medication.

A case of Hemichorea-Hemiballism Induced by Acute Infarction of Bilateral Corona Radiata and Cortex

Movement disorders are a recognized complication of stroke. Here we present a case of hemichorea-hemiballism (HCHB) after stroke. Basal ganglia and thalamus are typically recognized as sites responsible for HCHB. The MRI scan showed acute infarction which was unexpectedly present in both sides of corona radiate and cortex, but not in basal ganglia. This cortical HCHB could have evolved due to hypoperfusion of basal ganglia undetectable at the MRI scan or due to interruption of excitatory connections from the cerebral cortex to basal ganglia.