Alteplase Reactions 1680, p25 - 2 Dec 2017 Hemichorea-Hemiballism: case report A 72-year-old woman developed hemichorea-hemiballism (HC-HB) after receiving alteplase [rtPA] [route, dosage and duration of treatment to reaction onset not stated]. The woman was presented to hospital due to left handed hemiparesis. Examinations revealed dysarthria, conjugate eye deviation to the right and spatial disorientation. She was then diagnosed with cardioembolic infarction. Consequently, she was administered alteplase. Her hemiparesis improved after nine hours, followed by choreic movements of left hand. The movements were pronationary and supinationary in nature, which further advanced to ballistic arm movements within a day. The ballistic movement progressed to left-lower extremity, which confirmed hemichorea-hemiballism syndrome. MRI scans were negative for basal lesions including the subthalamic nucleus. A single-photon emission CT scan revealed hypoperfusion in the affected cortical lesion and an increased blood flow to the right basal ganglia. The woman’s symptoms resolved on the ninth day of hospitalisation. Follow-up brain MRI’s revealed cortical laminar necrosis along with atrophic changes in the stroke lesion. Author comment: "We observed transient HC-HB in a patient with a cerebral infarction in the temporal-parietal lobe without any lesions in the basal ganglia including the STN after intravenous recombinant tissue plasminogen activator (rtPA) administration." Murakami T, et al. Hemichorea-Hemiballism in a Patient with Temporal-Parietal Lobe Infarction Appearing After Reperfusion by Recombinant Tissue Plasminogen Activator. Movement Disorders Clinical Practice 2: 426-428, No. 4, Dec 2015. Available from: URL: - Japan 803284584 0114-9954/17/1680-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved Reactions 2 Dec 2017 No. 1680 Reactions Weekly Springer Journals


Reactions Weekly , Volume 1680 (1) – Dec 2, 2017
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Springer International Publishing
Copyright © 2017 by Springer International Publishing AG, part of Springer Nature
Medicine & Public Health; Drug Safety and Pharmacovigilance; Pharmacology/Toxicology
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