Vascular Hemiballismus Due to Extraluysian Lesions

Abstract

Hemiballismus represents a rare variety of hyperkinetic movement disorders that can complicate early-stage stroke. It is classically seen in contralateral Luysian lesions. We present the case of a 63-year-old hypertensive patient consulted for the sudden onset of involuntary movements. The neurological examination revealed right hemiballismus. Brain CT scan showed lacunar images of the internal capsule and left subthalamic muscles. The integrity of the subthalamic nucleus (STN) was confirmed by brain magnetic resonance image. The etiological assessment concluded that it was paroxysmal atrial fibrillation. The evolution was favorable after treatment with haloperidol. Hemiballismus represents less than 7% of movement disorders. It is usually linked to a vascular lesion of the contralateral STN. Extraluysian involvement remains rare.