Treatment of Hemiballismus
Hemiballismus/hemichorea is characterized by unilateral, involuntary writhing and flinging movements of acute or subacute onset. It is seen most commonly secondary to stroke or nonketotic hyperosmolar hyperglycemia. The subthalamic nucleus was previously thought to be the responsible anatomical site but recent studies have shown that lesions in other structures in the basal ganglia and cortex can produce a similar clinical picture. The majority of the cases have a good prognosis and most resolve spontaneously. Dopamine depleters (including VMAT2 inhibitors) and dopamine antagonists are the mainstay of the treatment. In severe cases, deep brain stimulation (DBS) or pallidotomy can be considered as a treatment option.
KeywordsHemiballismus Hemichorea Chorea Ballismus Hyperglycemia, Stroke
The video Hemiballismus patient history demonstrates random continuous irregular movements involving the proximal and distal extremities, face, and trunk on the right side. These movements are characteristic of chorea with occasional larger amplitude movements signifying hemiballismus (MP4 45682 kb)