Abstract
Choreoathetosis of the upper limb as the first manifestation of contralateral substantia nigra (SN) lacunar infarction is extremely rare. We report a case of choreoathetosis of the right upper limb in a 60-year-old man with SN infarction. Emergency brain magnetic resonance imaging showed discrete lacunar infarction localized in the left SN. Magnetic resonance angiography showed atherosclerotic stenosis of the basilar artery and the left posterior cerebral artery. He was diagnosed with contralateral SN infarction and then treated with antiplatelet, loading-dose statins, and allopathic therapy to achieve a positive outcome. During the follow-up period, there was no recurrence of stroke, and his symptom of choreoathetosis resolved. More cases alike should be studied to achieve satisfactory outcomes through early diagnosis and appropriate treatments.
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