Clinical Spectrum of Movement Disorders after Stroke in Childhood and Adulthood

Abstract

Although rare, many different types of hyperkinetic and hypokinetic movement disorders have been described after both ischemic and hemorrhagic stroke in children and in adults. Current knowledge about these disorders comes from single case reports or small series of cases compiled from retrospective studies. Data from hospital-based studies suggest a prevalence of poststroke movement disorders ranging from 1.1 to 3.9%. However, despite the development of emergency care for stroke, these clinical syndromes remain insufficiently recognized. Poststroke movement disorders take place in the acute phase or following a variable delay after stroke onset, and could be transient or persistent. Dystonia is the most frequent movement disorder, occurring after a delay of several months, while chorea and hemiballism are most frequent in the acute stages. Amongst transient movement disorders, limb shaking is associated with high-grade stenosis or occlusion of the internal carotid artery, while myoclonus and asterixis are rare. From a pathophysiological point of view, most of these symptoms are induced by a lesion involving the basal ganglia, the thalamus, or the frontal subcortical pathways. In this article, we updated the clinical spectrum, neuropathophysiological mechanisms, and prognosis of stroke-induced movement disorders in adults and children.

Hyperkinetic Movement Disorder Secondary to Punctate Hemorrhage in Lateral Ventricle Lining

“…However, in multiple clinical case series, non-STN lesions have also been shown to cause hyperkinetic movements, especially in stroke patients [5]. Pathology of the incoming and outgoing fibers to and from the STN may manifest as hemiballismus, which may explain the few cases of frontal and parietal strokes (MCA distribution) that presented with hyperkinetic movements in rare case reports [1, 6]. However, the exact cortical circuit projecting into the basal ganglia is still not completely known.…”

Unilateral movement disorder as a presenting sign of paediatric post-varicella angiopathy

“…The incidence of post-stroke movement disorders in children is unknown, but is assumed to be higher than in adults 2. Most publications are single case reports or small case series 2 11.…”

“…Most publications are single case reports or small case series 2 11. Haemidystonia as a consequence of stroke occurs more often in children than in adults, but particularly in the chronic stage 4.…”

Paciente con postura anómala en la mano derecha

“…La prevalencia de trastornos del movimiento tras un ictus oscila entre el 1.1 y el 3.9% 5,6 . Pueden producirse en la fase aguda de la isquemia siendo la corea el más habitual.…”

“…Pueden producirse en la fase aguda de la isquemia siendo la corea el más habitual. En ocasiones comienza después de varios meses del episodio agudo, siendo entonces la distonía el más frecuente 5,7 .…”