Alternating Paroxysmal Hemiballism-Hemichorea in Bilateral Internal Carotid Artery Stenosis.

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  • SHIMIZU Toshio
    the Departments of Neurology, Tokyo Metropolitan Neurological Hospital
  • HIROKI Masahiko
    the Departments of Neurology, Tokyo Metropolitan Neurological Hospital
  • YAMAOKA Yumiko
    the Departments of Neurology, Tokyo Metropolitan Neurological Hospital
  • KATO Shuichi
    the Departments of Neurology, Tokyo Metropolitan Neurological Hospital
  • SUDA Minami
    the Departments of Neurology, Tokyo Metropolitan Neurological Hospital
  • IDE Katsuhisa
    the Departments of Neurosurgery, Tokyo Metropolitan Neurological Hospital
  • YAGISHITA Akira
    the Departments of Neuroradiology, Tokyo Metropolitan Neurological Hospital
  • HIRAI Shunsaku
    the Departments of Neurology, Tokyo Metropolitan Neurological Hospital

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A 72-year-old man presented with paroxysmal and transient involuntary movements, or "limb shaking". The attacks occurred alternately from one side of the body to the other and ceased spontaneously. Surface EMG study showed synchronous grouping discharges in multiple limb muscles, being compatible with hemiballism-hemichorea. Cerebral angiography demonstrated marked stenosis of the bilateral internal carotid arteries. Bilateral carotid endarterectomy led to complete disappearance of the involuntary movements. Alternating paroxysmal hemiballismhemichorea might be a transient ischemic attack, and alternating striatal dysfunction induced by cerebral hemodynamic or microembolic ischemia probably plays a central role in the occurrence of such involuntary movements.<br>(Internal Medicine 40: 808-812, 2001)

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  • Internal Medicine

    Internal Medicine 40 (8), 808-812, 2001

    一般社団法人 日本内科学会

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