11/28. Hemiballism after subthalamotomy in patients with Parkinson's disease: report of 2 cases.The occurrence of persistent hemiballism after subthalamotomy for Parkinson's disease (PD) has not been described as frequently as mild or transient dyskinesia. We report on 2 patients with advanced PD who developed hemiballism and/or dyskinesia after subthalamotomy. One patient with a small lesion confined to the subthalamic nucleus (STN) developed persistent hemiballism; the other with a larger lesion involving the STN and also the zona incerta presented with a transient dyskinesia in a single limb. We conclude that a precise STN lesion might bear a potential risk of persistent hemiballism.- - - - - - - - - - ranking = 1keywords = limb (Clic here for more details about this article) |
12/28. Neurogenic pain and abnormal movements contralateral to an anterior parietal artery stroke.BACKGROUND: Unlike delayed pain syndrome, acute central pain is a very rare symptom in acute stroke. In addition, the incidence of hemiballismus in acute cerebrovascular diseases is less than 1%. To our knowledge, the association of these 2 clinical conditions has not been previously described. PATIENT AND methods: After observing one patient with hemiballismus accompanied by ipsilateral acute limb pain at stroke onset, we retrospectively examined more than 4000 patients in the Lausanne stroke Registry for hemiballismus-hemichorea occurring together with acute ipsilateral pain. RESULTS: Of the 29 subjects with hemiballismus-hemichorea, the observed patient was the only one to have acute pain at the onset of stroke. magnetic resonance imaging showed acute infarction in the territory of the right anterior parietal artery, whereas the basal ganglia, thalamus, and subthalamic region were intact. CONCLUSIONS: The syndrome of acute limb pain associated with hemiballismus may result from disconnection of the parietal lobe from deeper structures. In contrast with isolated hemiballismus, we suggest that the simultaneous occurrence of this movement disorder with ipsilateral pain is specific for an anterior parietal artery stroke.- - - - - - - - - - ranking = 2keywords = limb (Clic here for more details about this article) |
13/28. Transient ischemic attacks presenting as hemiballism.Hemiballism is continuous, nonpatterned involuntary movement characterized by irregular, coarse, flinging movement involving the limbs on one side. Hemiballism is most commonly caused by stroke. However, very rarely a transient ischemic attack (TIA) presents as hemiballism. We describe 2 such patients with hemiballism presenting as TIA.- - - - - - - - - - ranking = 1keywords = limb (Clic here for more details about this article) |
14/28. Hemiballismus following general anesthesia. A case report.Hemiballismus is characterized by the abrupt onset of violent proximal flinging movements, affecting the limbs, neck and trunk on one side of the body. It is caused by the lesion in the region of the contralateral subthalamic nucleus of the Luys. Usually it is a self-limiting disease, lasting 6-8 weeks. A 49-year-old man has been admitted to the hospital after flinging movements of his right arm and the right side of the trunk occurred. A few days earlier he had undergone general anesthesia prior to a dental procedure. There was trouble in waking the patient afterwards. The movements lasted a few days. MRI of the brain revealed ischemic lesions areas in T2-weighted images localized in the region of globus pallidus bilaterally. EEG was abnormal, and showed slowed background activity with slow waves in left temporal lobe. He was treated with haloperidol, clonazepam and vasoactive medications. In spite of administered treatment, hemiballic movements reappeared occasionally. Due to increased frequency of the movements the patient was hospitalized again two years later. The second MRI revealed changes described earlier and a new ischaemic focus in left parietal lobe. Continuation of treatment with haloperidol was administered.- - - - - - - - - - ranking = 1keywords = limb (Clic here for more details about this article) |
15/28. alien hand syndrome: contradictive movement and disorder of color discrimination.A senile Chinese female patient with alien hand syndrome of vascular etiology is reported. This case exhibited contradictive movement, left-lateral paresis and disorder of color discrimination, which might be a new subtype of the alien limb syndrome.- - - - - - - - - - ranking = 1keywords = limb (Clic here for more details about this article) |
16/28. Treatment of hemiballismus with stereotactic pallidotomy. Case report and review of the literature.Hemiballismus is a relatively rare movement disorder that is characterized by uncontrolled, random, large-amplitude movements of the limbs. It is usually caused by a vascular lesion that involves the contralateral subthalamic nucleus (STN) (also known as the nucleus hypothalamicus or corpus luysi) and its afferent and efferent pathways. The authors present a case of medically intractable hemiballismus in a 70-year-old woman who was successfully treated with stereotactic posteroventral pallidotomy. In agreement with the data reported earlier by other groups, the microrecording performed during the pallidotomy showed a decreased rate of firing of the pallidal neurons, supporting the theory of impaired excitatory input from the STN to the internal part of the globus pallidus. Stereotactic pallidotomy may be the procedure of choice in the treatment of medically intractable hemiballismus. Intraoperative microrecording significantly improves the precision of the stereotactic targeting and should be considered a standard part of the pallidotomy protocol.- - - - - - - - - - ranking = 1keywords = limb (Clic here for more details about this article) |
17/28. Posterior alien hand syndrome: case report and rehabilitative treatment.alien hand syndrome (AHS) is a rare syndrome characterized by involuntary, uncontrollable, and purposeless movement of one upper limb, which is considered as extraneous by the patient. The term AHS was previously used to describe a syndrome due to lesions in the anterior corpus callosum. Successively, some authors reported cases of AHS in patients due to posterior cerebral lesions, without lesions of the corpus callosum. Thus, it was possible to distinguish the posterior variant of AHS from the anterior form. The authors report an unusual case of posterior AHS due to a unique parieto-occipital lesion of the dominant hemisphere. However, the patient showed clinical findings that were similar to the anterior AHS. The rehabilitative treatment, individualized and targeted toward the specific needs of the patient, allowed the improvement of the patient's participation in activities of daily living.- - - - - - - - - - ranking = 8.1432647686077keywords = upper limb, limb, upper (Clic here for more details about this article) |
18/28. Paroxysmal alien limb phenomena due to epileptic seizures and electrical cortical stimulation.Alien limb phenomena (ALPs) are characterized by limb movements, which are subjectively experienced as involuntary or alien induced. ALPs regularly remain unchanged and occur as a consequence of frontal, callosal, or posterior cerebral lesions. The authors present two patients with paroxysmal ALP proved to be focal seizures by using video-EEG monitoring. In another two patients, ALP could experimentally be induced by electrical cortical stimulation. Based on the stimulation results, the authors suspect a functional disconnection of 1) sensory cortical areas providing information about the extrapersonal space; and 2) areas of the frontal and/or limbic cortex that are regularly involved in the processing and executing of intentional motor activity as a pathophysiologic substrate for ictal ALP.- - - - - - - - - - ranking = 7keywords = limb (Clic here for more details about this article) |
19/28. Position-dependent levitation of the dominant arm after left parietal stroke: an unreported feature of posterior alien limb syndrome?We describe a patient with an unreported feature of posterior alien limb phenomenon characterized by position-dependent levitation of the dominant arm exacerbated by tactile stimulation and associated with low-amplitude tremor of the fingers of the right hand in addition to a sensation of strangeness in the arm, secondary to a left parietal stroke.- - - - - - - - - - ranking = 5keywords = limb (Clic here for more details about this article) |
20/28. Repetitive involuntary leg movements in patients with brainstem lesions involving the pontine tegmentum: evidence for a pontine inhibitory region in humans.Repetitive involuntary limbs movements have been mostly reported in patients with extensive brainstem pathologies, but the region responsible is unknown. We describe two patients with progressive basilar artery infarcts who showed automatic stepping and one patient with an osmotic demyelination disorder who showed periodic involuntary leg movements. By subtracting diffusion-weighted images before and after the development of repetitive involuntary leg movements, the brainstem lesion responsible for the involuntary movements was distinctively located in the vicinity of the pontine tegmentum, which is known as the pontine inhibitory region in animal studies.- - - - - - - - - - ranking = 1keywords = limb (Clic here for more details about this article) |
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