A 65-year-old male begins to experience involuntary swings of moderate amplitude involving the left arm. He had a stroke three months ago. This has led to an incident whereby he hit a child with his arm whilst at the supermarket and now he is being questioned by the police. Which of the following do you suspect?
Exam Question Jul 2014
Hemiballismus is a rare movement disorder that typically develops after a stroke involving the basal ganglia (specifically the subthalamic nucleus). It is usually characterized by involuntary flinging motions of the extremities. The movements are often violent and have wide amplitudes of motion. They are continuous and random and can involve proximal and/or distal muscles on one side of the body.
Exam Question Jul 2014
Hemiballismus is a rare movement disorder that typically develops after a stroke involving the basal ganglia (specifically the subthalamic nucleus). It is usually characterized by involuntary flinging motions of the extremities. The movements are often violent and have wide amplitudes of motion. They are continuous and random and can involve proximal and/or distal muscles on one side of the body.
Movement disorders
Movement disorders in psychiatry
The following definitions need to be learnt.
Akinesia - absence, poverty, or loss of control of voluntary muscle movements. This is seen in severe Parkinson's disease.
Bradykinesia - slowness of movement, core symptom in Parkinson's disease along with tremor and rigidity.
Akathesia - subjective feeling of inner restlessness, most often caused by side effect of neuroleptic medication, often manifests as inability to sit still.
Athetosis - continuous stream of slow, flowing, writhing involuntary movements.
Chorea - brief, quasi-purposeful, irregular contractions that are not repetitive or rhythmic, but appear to flow from one muscle to the next.
Dystonia - sustained muscle contractions cause twisting and repetitive movements or abnormal postures.
Dyskinesia - general term referring to problems with voluntary movements and the presence of involuntary movements.
Myoclonus - Sudden involuntary jerks of a muscle or a muscle group. These are not suppressible.
Parkinsonism - syndrome characterized by tremor, rigidity, and bradykinesia.
Tic - sudden, repetitive, non rhythmic, stereotyped motor movement or vocalization involving discrete muscle groups. These are different to myoclonus as they are suppressible.
Tremor - involuntary, rhythmic, alternating movement of one or more body parts.
Hemiballismus - repetitive, but constantly varying, large amplitude involuntary movements of the proximal parts of the limbs
