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General Practice 2023

Hemiballismus: meaning and how to treat

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Hemiballismus: meaning and how to treat
Hemiballismus: meaning and how to treat

Hemiballismus, also known as hemichorea, is a disorder characterized by the occurrence of involuntary and sudden movements of the limbs, of great amplitude, which may also occur in the trunk and head, only on one side of the body.

The most common cause of hemiballismus is ischemic or hemorrhagic stroke, also known as stroke, but there are other causes that can lead to it.

Generally, the treatment consists of resolving the cause of the disorder, and anti-dopaminergic, anticonvulsant or antipsychotic drugs may also be administered.

Possible causes

Generally, hemiballismus occurs due to lesions in the subthalamic nucleus of Luys or surrounding regions, which result from sequelae caused by an ischemic or hemorrhagic stroke. However, this disorder can also be caused by:

  • Focal lesions in the structures of the basal ganglia, due to a tumor, vascular malformations, tuberculomas or demyelinating plaques;
  • Systemic lupus erythematosus;
  • Head trauma;
  • Influenza type A virus infections;
  • Hyperglycemia;
  • HIV Infections;
  • Wilson's Disease;
  • Toxoplasmosis.

In addition, hemiballismus can also result from side effects of medications such as levodopa, contraceptives, and anticonvulsants.

What are the symptoms

Symptoms associated with hemiballismus are loss of movement control, occurrence of rapid, violent and involuntary large-amplitude muscle spasms on one side of the body and on the opposite side of the lesion. In some cases, it can also affect the facial muscles and cause lack of balance when walking.

When the person moves or performs some action, the involuntary movements become more intense and may disappear at rest or during sleep.

Why it happens

Hemiballismus occurs due to a lesion in the subthalamic nucleus, which causes a decrease in inhibitory impulses from the basal ganglia on the spinal cord, cerebral cortex and brainstem, interfering with movements.

How the treatment is done

Treatment of hemiballismus should focus on the underlying cause. In addition, dopamine blockers can be prescribed, which can reduce involuntary movements by up to 90%.

In some cases, the doctor may also prescribe medications such as sertraline, amitriptyline, valproic acid or benzodiazepines.

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