Transient hemiballism/hemichorea due to an ipsilateral subthalamic nucleus infarction

Abstract

Hemiballism usually results from vascular lesions of the subthalamic nucleus (STN), its afferent or efferent pathways, or its projection areas (thalamus, striatum, and lenticular nucleus). Most often, the lesions are contralateral to the abnormal limb, but there may be ipsilateral lesions (review [1]). Precise correlation between the ipsilateral lesion and the abnormal movements is uncertain, because the lesions are usually multiple and often bilateral. We report a case of transient hemiballism/hemichorea that occurred with an isolated ischemic lesion of the ipsilateral STN. A 63-year-old man, without previous history of neurologic or systemic disease, was awakened on May 5, 1994, by a sudden onset of abnormal movements of the left side of the body. Involuntary movements involved the proximal aspect of the upper and lower limbs and were violent, irregular, and associated with flexion and rotation. There were also irregular choreic movements of the left hand. All these movements were exaggerated when the …