title: Hyperkinetic movement disorders during and after acute stroke: the Lausanne Stroke Registry.
abstract: OBJECTIVE
  To study consecutive patients with acute or delayed hyperkinetic movement disorders in the Lausanne Stroke Registry.
  
  
  METHODS
  We have identified 29 patients with acute or delayed movement disorders among 2500 patients who had their first-ever acute stroke in the Lausanne Stroke Registry.
  
  
  METHODS
  Department of Neurology, Lausanne University Hospital.
  
  
  RESULTS
  Our patients presented with hemichorea-hemiballism (11 patients), hemidystonia (5 patients), stereotypias (2 patients), jerky dystonic unsteady hand (3 patients), asterixis (2 patients), initial limb-shaking (2 patients), bilateral tremor (1 patients), bilateral jaw myoclonus (1 patient), hemiakathisia (1 patient) and dysarthria-dyskinetic hand (1 patient). On neuroimaging a lesion was found in 25 of the 29 cases in the territory of the middle cerebral artery (7 deep, 2 superficial and 2 complete), the posterior cerebral artery (11 patients), both middle and posterior cerebral arteries (2 patients) or the anterior cerebral artery (1 patient). The jerky dystonic unsteady hand syndrome was associated with a specific lesion, an infarct in the territory of the posterior choroidal artery. Presumed small-vessel disease was the commonest cause of stroke (15 patients). Only 3 patients had persistent movements (> 6 months).
  
  
  CONCLUSIONS
  Hyperkinetic movement disorders are uncommon in acute stroke (1%), the commonest types being hemichorea-hemiballism and hemidystonia. These movement disorders are associated with stroke involving the basal ganglia and adjacent white matter in the territory of the middle or the posterior cerebral artery. The jerky dystonic unsteady hand syndrome is specifically associated with a small infarct in the territory of the posterior choroidal artery. The abnormal movements usually regress spontaneously.
authors.affiliation: Department of Neurology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
authors.forename: F
authors.initials: F
authors.lastname: Ghika-Schmid
authors.forename: J
authors.initials: J
authors.lastname: Ghika
authors.forename: F
authors.initials: F
authors.lastname: Regli
authors.forename: J
authors.initials: J
authors.lastname: Bogousslavsky
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002561:Cerebrovascular Disorders / Q000150:complications*; D002819:Chorea / Q000000981:diagnostic imaging / Q000209:etiology*; D018450:Disease Progression; D004421:Dystonia / Q000000981:diagnostic imaging / Q000209:etiology*; D005260:Female; D006801:Humans; D006948:Hyperkinesis / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed