[A case of hemiballism successfully treated by sulpiride, caused by lesions of the striatum].

A case of hemiballism caused by infarction in the left striatum on MRI was reported. Hemiballism is generally associated with lesions in the subthalamic nucleus. However, hemiballism occasionally occurs as a result of lesions outside the subthalamic nucleus. Hemiballism is a benign condition with spontaneous recovery in most cases, but hemiballism caused by lesions outside the subthalamic nucleus is reported to tend to persist for a long term. In our case without involvement of the subthalamic nucleus, hemiballism so far continued for three months since the onset. Successful pharmacological treatments of ballism with haloperidol or phenothiazines were well known. In our case, the treatments of ballism with these drugs were unsuccessful due to drug-induced hepatic dysfunction. Instead of these drugs, ballism was improved by administration of 150 mg of sulpiride per day with no side effects. Sulpiride may be beneficial for persistent hemiballism caused by the extra subthalamic lesions.