Chapter 11 - Abnormal movements in stroke

Summary

Acute, paroxysmal, recurrent, transient, permanent, and delayed movement disorders are occasionally reported in patients during the acute phase of stroke, or as delayed syndromes months or years after an acute vascular lesion. This chapter provides an overview on hyperkinetic manifestations of stroke. Transient or paroxysmal hemichorea-hemiballism can be difficult to distinguish from limb shaking, and has occasionally been considered as a vertebrobasilar transient ischemic attack (TIA). Orofacial dyskinesias have been found in a few patients with brainstem infarcts, associated with palatal myoclonus in one patient, and after thalamic infarcts. Mental dystonia has been reported in association with a posteroventrolateral thalamic infarct. Head or cervical tremor can develop in bilateral thalamic and midbrain infarcts and in bilateral cerebellar infarcts. Unilateral asterixis has been reported with contralateral lesions involving any structure involved with motion, and also with lesions in the territory of the PCA and particularly in patients with ipsilateral brainstem stroke.