Pearls & Oy-sters: Resolution of hemichorea following endarterectomy for severe carotid stenosis

Neurology Department, Wessex Neurosciences Centre, Mailpoint 101, Level B, Southampton University Hospital Trust, Tremona Road, Southampton SO16 6YD, UK.
Neurology (Impact Factor: 8.3). 01/2009; 71(24):e80-2. DOI: 10.1212/01.wnl.0000336975.80810.74
Source: PubMed
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    ABSTRACT: Hemiballism is a rare movement disorder characterized by a high amplitude movement of an entire limb or limbs on one side of the body. The acute development of hemiballismus is often caused by focal lesions in the contralateral basal ganglia and STN. Many etiologies exist for this rare disorder with vascular causes and nonketotic hyperglycemia being the most common. Clearer understanding of the pathophysiology of hemiballism has led to important insights into the function and interaction of structures within the basal ganglia. Newer models of basal ganglia function have been proposed based on the study of the pathophysiology of hemiballism. Prognosis is favorable for most patients with complete resolution with or without treatment. Medical and surgical treatments are often successful in reducing or completely ameliorating the movements in those patients with more severe movements.
    Parkinsonism & Related Disorders 09/2011; 18(2):125-9. DOI:10.1016/j.parkreldis.2011.08.015 · 4.13 Impact Factor
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    ABSTRACT: Involuntary movement associated with deep watershed ischemic lesions has been rarely reported. A 67-year-old woman presented with acute hemichorea on the left side. Magnetic resonance imaging showed acute infarcts in the anterior border zone. On perfusion studies, impaired cerebral blood flow was observed on the subcortical region sparing the basal ganglia. Cerebral angiogram confirmed severe stenosis in the right internal carotid artery. Her hemichorea gradually improved along with normalization of perfusion after carotid artery stenting with angioplasty. We suggest that impaired cerebral blood flow in critical watershed territories may be an important contributing factor in hemichorea associated with carotid occlusive disease.
    05/2013; 6(1):17-20. DOI:10.14802/jmd.13004
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    ABSTRACT: 2009;12(1): 30-34 ÖZET Hemikore serebrovasküler hastalıklarda nadir görülen bir bulgu olup, genellikle karşı taraf bazal gangliyon, talamus ve korona radiyatada iskemik lezyonları sonucu ortaya çıkar. Ciddi karotis arter stenozuna bağlı serebral hipoperfüzyon ile hemikore oluşması ise oldukça nadirdir. Vasküler nedenli hemikore olgularının tedavisi ve prognozu da belirsizdir. Bu sunumda geçici iskemik atakları ve internal karotis arterinde ciddi darlığı olan, akut hemikore gelişmiş bir olgunun karotis arter stent anjiyoplastisi sonrası düzeldiğini bildirilmektedir. Anahtar Kelimeler: Kore, karotis arter, stent, anjiyoplasti SUMMARY Hemichorea is a rare symptom of cerebrovascular diseases and occasionally occurs as a result of ischemic lesions of the basal ganglia, thalamus and corona radiata. As a cause of hemichorea, cerebral hypoperfusion due to severe carotid artery stenosis is very rare. The treatment and the prognosis of hemichorea due to vascular etiology are also unclear. In this paper we report resolution of hemichorea in a patient with transient ischemic attacks and severe carotid artery stenosis after the angioplasty and stenting procedure of the carotid artery.