Clinical features of hemichoreahemiballism: A stroke-related movement disorder

Nobuko Shiraiwa; Sachiko Hoshino; Go Saito; Akira Tamaoka; Norio Ohkoshi

doi:10.4081/ni.2020.8328

Clinical features of hemichoreahemiballism: A stroke-related movement disorder

Neurol Int. 2020 Jul 10;12(1):8328. doi: 10.4081/ni.2020.8328.

Authors

Nobuko Shiraiwa^{1

2}, Sachiko Hoshino², Go Saito³, Akira Tamaoka⁴, Norio Ohkoshi^{1

5}

Affiliations

¹ Course of Neurology, Department of Health Sciences, Tsukuba University of Technology.
² Department of Neurology, Tsukuba Memorial Hospital.
³ Primary Care and Medical Education, Graduate School of Comprehensive Human Sciences, University of Tsukuba.
⁴ Department of Neurology, Graduate School of Comprehensive Human Science, University of Tsukuba.
⁵ Department of Radiological Technology, Tsukuba International University, Japan.

Abstract

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.

Keywords: Hemichorea-hemiballism; Strokerelated movement disorders; basal ganglia.