Post-stroke hemichorea: observation-based study of 15 cases
Pareés, I.; Hernández-Vara, J.; Álvarez-Sabín, J.é
Revista de Neurologia 51(8): 460-464
2010
ISSN/ISBN: 1576-6578 PMID: 20925027 Document Number: 642945
Chorea is an infrequent complication of acute cerebrovascular disease or stroke. The pathophysiology, the exact location of the lesions and the clinical course of this type of chorea are still not fully understood. To conduct a retrospective observation-based study of patients diagnosed with vascular hemichorea in our centre. The study involved consecutive patients diagnosed with this condition who were attended between the years 2004 and 2009. A descriptive analysis of their clinico-radiological characteristics and clinical symptoms was performed. Fifteen patients were included in the study, which represented 0.2% of the cases of stroke attended during the period under analysis. The mean age was 73 years. Twelve patients (80%) presented an ischaemic stroke and three patients (20%) had a haemorrhagic stroke. The location of the lesions varied. The most frequent site was in the lentiform nucleus, followed by those with located in the cortical, thalamic and sub thalamic regions. Eight patients (53%) did not require pharmacological treatment owing to the scarce repercussion of their symptoms or their rapid resolution. The most commonly employed treatment was haloperidol. The mean follow-up time was 17 months. Over that period, the hemi-chorea disappeared in 11 patients (73%), most of them before the end of the second month of progress of the disease. The variable topography of the lesions related to hemichorea is proof of the complexity of the functioning of the cortico-basal network to control movement and confirms the association between hemichorea and cortical lesions.