Post-stroke movement disorders: report of 56 patients

Abstract

Background: Although movement disorders that occur following a stroke have long been recognised in short series of patients, their frequency and clinical and imaging features have not been reported in large series of patients with stroke. Methods: We reviewed consecutive patients with involuntary abnormal movements (IAMs) following a stroke who were included in the Eugenio Espejo Hospital Stroke Registry and they were followed up for at least one year after the onset of the IAM. We determined the clinical features, topographical correlations, and pathophysiological implications of the IAMs. Results: Of 1500 patients with stroke 56 developed movement disorders up to one year after the stroke. Patients with chorea were older and the patients with dystonia were younger than the patients with other IAMs. In patients with isolated vascular lesions without IAMs, surface lesions prevailed but patients with deep vascular lesions showed a higher probability of developing abnormal movements. One year after onset of the IAMs, 12 patients (21.4%) completely improved their abnormal movements, 38 patients (67.8%) partially improved, four did not improve (7.1%), and two patients with chorea died. In the nested case-control analysis, the patients with IAMs displayed a higher frequency of deep lesions (63% v 33%; OR 3.38, 95% CI 1.64 to 6.99, p,0.001). Patients with deep haemorrhagic lesions showed a higher probability of developing IAMs (OR 4.8, 95% CI 0.8 to 36.6). Conclusions: Chorea is the commonest movement disorder following stroke and appears in older patients. Involuntary movements tend to persist despite the functional recovery of motor deficit. Deep vascular lesions are more frequent in patients with movement disorders.

Hemiballismus That Develops upon Thalamic Hemorrhage: A Case Report

“…Bir çalışmada inme ile takip edilen 1500 hastanın 56'sında; bir yıl içerisinde istemsiz hareket bozukluğu gelişmiştir. Hastaların; %35,7'sinde kore, %25'inde tremor, %28,5'inde distoni, %6'sında parkinsonizm gelişmiştir (21).…”

Diffusion tensor imaging to determine the potential motor network connectivity between the involved and non-involved hemispheres in stroke

“…An edge e in the EBC is defined as the fraction of shortest paths between any two adjacent nodes i and j that pass through an edge. (2) where N is the set of nodes, σ ij represents the number of shortest neural pathways between nodes i and j, and σ ij (e) denotes the number of shortest paths between nodes i and j that pass through the edge. A zero EBC indicates the absence of connections between nodes.…”

“…Depending on the specific cortical or subcortical network lesions, it is often implicated with a wide range of important functional motor impairments such as walking and reaching [1,2]. MRI has been used to accurately diagnose cerebral lesions after CVA; however, the integrity and connectivity of the whole brain, which may represent important diagnostic and prognostic biomarkers for neurorehabilitation [3], have not been fully investigated.…”

İskemik inme sonrası gelişen hemikore

“…Hemikore-hemiballismusta sıklıkla orta serebral arter, posterior serebral arter ve nadiren de anterior serebral arter etkilenir 5,6 . Hemikore lentiform nükleus veya talamusu etkileyen vasküler olaylar sonrası sıklıkla bildirilmiştir 2,3,6,7 . İskemik inme, hemoraji gibi vasküler olayların yanında otoimmün-genetik hastalıklar, metabolik endokrin bozukluklar, enfeksiyonlar gibi çok sayıda hastalık hemikore ve hemiballismusa neden olabilmektedir 6,8 .…”