Li Zhao-Sheng, Fang Jia-Jia, Xiang Xiao-Hui, Zhao Guo-Hua
Department of Neurology, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu 322000, Zhejiang Province, China.
World J Clin Cases. 2021 Jul 6;9(19):5287-5293. doi: 10.12998/wjcc.v9.i19.5287.
Hemichorea usually results from vascular lesions of the basal ganglia. Most often, the lesion is contralateral to the affected limb but rarely, it may be ipsilateral. The pathophysiology of ipsilateral hemichorea is still poorly understood. We review the literature on hemichorea due to ipsilateral cerebral infarction and explore possible mechanisms for its occurrence.
A 72-year-old woman presented with complaints of involuntary movements of the muscles of the left side of the face and mild weakness of the right limbs. Her symptoms had started suddenly 1 d earlier. After admission to the hospital, the involuntary movements spread to involve the left limbs also. Magnetic resonance imaging revealed a left thalamic infarction. The patient's hemichorea subsided after treatment with haloperidol (2 mg per time, 3 times/d) for 3 d; the hemiparesis resolved with rehabilitation physiotherapy. She is presently symptom free and on treatment for prevention of secondary stroke. We review the literature on the occurrence of ipsilateral hemichorea following thalamic infarction and discuss the possible pathomechanisms of this unusual presentation.
Ipsilateral hemichorea following a thalamic stroke is rare but it can be explained by structure of the extrapyramidal system. The thalamus is a relay station that exerts a bilateral control of motor function.
偏侧舞蹈症通常由基底节区血管病变引起。病变大多位于受累肢体的对侧，但极少情况下可能位于同侧。同侧偏侧舞蹈症的病理生理学仍知之甚少。我们回顾了有关同侧脑梗死所致偏侧舞蹈症的文献，并探讨其发生的可能机制。
一名72岁女性，主诉左侧面部肌肉不自主运动及右侧肢体轻度无力。症状于1天前突然出现。入院后，不自主运动蔓延至左侧肢体。磁共振成像显示左侧丘脑梗死。患者经氟哌啶醇（每次2mg，每日3次）治疗3天后偏侧舞蹈症缓解；偏瘫经康复理疗后恢复。她目前无症状，正在接受预防继发性中风的治疗。我们回顾了有关丘脑梗死后同侧偏侧舞蹈症发生的文献，并讨论了这种不寻常表现的可能发病机制。
丘脑卒中后同侧偏侧舞蹈症虽罕见，但可由锥体外系结构解释。丘脑是一个对运动功能进行双侧控制的中继站。
