Haemiballism/haemichorea: an atypical presentation of ischaemic stroke.
Raman NohriaStacey BennettYasmin Ali O'KeefePublished in: BMJ case reports (2021)
A 76-year-old man was admitted to the hospital with acute onset of involuntary movements of the left side of his body. His neurological examination revealed he was oriented only to himself, and aforementioned movements of his left arm and leg. CT head demonstrated old infarcts in his right aspect of his pons and basal ganglia. Cerebrospinal fluid analysis was unremarkable. He initially had a normal blood glucose with an elevated anion gap and elevated creatine kinase. Brain MRI showed a small lacunar-type ischaemic infarct within the anteromedial aspect of the right cerebral peduncle, which localised to his haemiballism. To prevent worsening rhabdomyolysis associated with his haemiballism, the primary team initiated both tetrabenazine and diazepam. His movements improved after 1 week of medication therapy. This report discusses a thorough workup for this movement disorder and when to intervene for this distressing condition.
Keyphrases
- blood glucose
- cerebrospinal fluid
- contrast enhanced
- cerebral ischemia
- healthcare
- liver failure
- magnetic resonance imaging
- computed tomography
- glycemic control
- acute kidney injury
- adverse drug
- palliative care
- respiratory failure
- acute myocardial infarction
- blood pressure
- subarachnoid hemorrhage
- white matter
- resting state
- randomized controlled trial
- aortic dissection
- type diabetes
- emergency department
- case report
- heart failure
- clinical trial
- acute care
- adipose tissue
- stem cells
- mesenchymal stem cells
- magnetic resonance
- coronary artery disease
- skeletal muscle
- weight loss
- acute respiratory distress syndrome
- multiple sclerosis
- acute coronary syndrome
- study protocol
- electronic health record
- placebo controlled
- replacement therapy
- anterior cruciate ligament reconstruction
- pet ct