Clinical and CT-findings in Hemiballismus

Abstract

We studied the correlation between clinical and CT-findings in 33 cases with hemiballismus. Of these 33 cases, 4 cases were examined by the authors and 29 cases were obtained from the literature. Cerebrovascular disease was present in 27 cases and the localization of the lesion was examined with CT. Of these 10 cases had lesions in the subthalamus, while 17 cases had lesions outside the subthalamus. In 6 cases, the location of the lesion was not recognized on CT. In cases with lesions outside the subthalamus, 11 cases had lesions in the putamen, 10 cases had lesions in the caudate. Therefore the lesion were largely located in the striatum. Typical hemiballismus was seen in 16 cases. In this group, 6 cases had lesions in the subthalamus, 5 cases had lesions in the putamen, and 3 cases had lesions in the caudate. Hemiballismus accompanied by hemichorea was seen in 17 cases. In this group, while 9 cases had hemichorea with ballismus, and 5 out of 9 cases had lesions in the caudate, 4 cases had lesions in the putamen. Thus, all lesions were located in the striatum. Eight out of 17 cases had hemiballismus with chorea. In these 8 cases, 4 cases had lesions in the subthalamus, these were 2 cases in the putamen, and 2 cases had lesions in the caudate. When all cases were examined in terms of clinical manifestations, 10 cases were considered to have lesions in the caudate and 7 out of 10 cases involved chorea. Ten cases had lesions in the subtalamus, while 6 out of 10 cases showed typical hemiballismus. From these observation, typical hemiballismus was largely seen in cases with lesions in the subthalamus, while in cases which involved chorea, the lesions tended to involve the striatum, especially the caudate.