Hemiballism as First Isolated Manifestation Following Caudate Infarction

Song, In Uk; Kim, Joong Seok; An, Jae Young; Ryu, Soen Young; Lee, Sang Bong; Lee, Kwang Soo

Case Report

Journal of the Korean Geriatrics Society 2007;11(3):170-173.
Published online September 30, 2007.

Hemiballism as First Isolated Manifestation Following Caudate Infarction

In Uk Song, Joong Seok Kim, Jae Young An, Soen Young Ryu, Sang Bong Lee, Kwang Soo Lee

Department of Neurology, College of Medicine, The Catholic University of Korea, Korea. ks1007@Catholic.ac.kr

순수 편측 발리즘으로 발현된 미상핵 경색

Abstract

Hemiballism is a rare hyperkinetic involuntary movement disorder that presents with unilateral forceful, flinging, large amplitude of proximal limbs. The most consistent neuropathological findings in hemiballism are a lesion of the contralateral subthalamic nucleus and pallidosubthalamic tract. However, we experienced a patient with pure hemiballism as isolated manifestation of acute ischemic stroke without other neurological abnormal symptoms such as chorea or dystonia. Brain magnetic resonance image showed acute ischemic stroke in right caudate nucleus but not subthalamic nucleus.

Key Words: Hemiballism, Caudate nucleus, Acute ischemic stroke

초 록

편측 발리즘은 강하고, 폭이 큰 불수의적 이상운동으로 근위부를 침범하는 매우 드문 증상이다. 신경병리학에 의하면 주 병소는 시상하핵과 담창구 시상하핵로이나, 드물게는 다른 병변에서도 나타날 수 있다. 이에 저자들은 급성 허혈성 뇌졸중의 첫 증상으로서 순수 편측 발리즘로만 발현된 57세 남자로, 뇌자기공명 검사에서 시상하핵이 아닌 우측 미상핵 경색을 가진 환자를 경험하였기에 이를 보고하는 바이다.