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      Movement Disorders Following Cerebrovascular Lesions: Etiology, Treatment Options and Prognosis

      review-article
      Author(s):
      Publication date (Electronic):
      Journal: Journal of Movement Disorders
      Publisher: The Korean Movement Disorders Society
      Keywords: Stroke, Movement disorders, Etiology, Treatment, Prognosis

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          Abstract

          Post-stroke movement disorders are uncommon, but comprise an important part of secondary movement disorders. These exert variable and heterogeneous clinical courses according to the stroke lesion and its temporal relationships. Moreover, the predominant stroke symptoms hinder a proper diagnosis in clinical practice. This article describes the etiology, treatment options and prognosis of post-stroke movement disorders.

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          Most cited references65

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          The phenotypic spectrum of CADASIL: clinical findings in 102 cases.

          T Klockgether, G Rungger, M Dichgans … (1998)
          Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is an increasingly recognized autosomal dominant disorder that leads to cerebrovascular manifestations in early adulthood. This study delineates the phenotypic spectrum and the natural history of the disease in 102 affected individuals from 29 families with biopsy-proven CADASIL. Recurrent ischemic episodes (transient ischemic attack [TIA] or stroke) were the most frequent presentation found in 71% of the cases (mean age at onset, 46.1 years; range, 30-66 years; SD, 9.0 years). Forty-eight percent of the cases had developed cognitive deficits. Dementia (28%) was frequently accompanied by gait disturbance (90%), urinary incontinence (86%), and pseudobulbar palsy (52%). Thirty-nine patients (38%) had a history of migraine (mean age at onset, 26.0 years; SD, 8.2 years), which was classified as migraine with aura in 87% of the cases. Psychiatric disturbances were present in 30% of the cases, with adjustment disorder (24%) being the most frequent diagnosis. Ten patients (10%) had a history of epileptic seizures. To delineate the functional consequences of ischemic deficits, we studied the extent of disability in different age groups. The full spectrum of disability was seen in all groups older than age 45. Fifty-five percent of the patients older than age 60 were unable to walk without assistance. However, 14% in this age group exhibited no disability at all. Kaplan-Meier analysis disclosed median survival times of 64 years (males) and 69 years (females). An investigation of the 18 multiplex families revealed marked intrafamilial variations.
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            Moyamoya disease--a review.

            J Suzuki, Eiichi N Kodama (2015)
            One hundred cases of Moyamoya disease were encountered between 1961 and 1980. This report describes the clinical characteristics and emphasizes the angiographic findings and clinical correlation in this disease. Reasons for the differences in clinical and radiological presentation in children versus adults are proposed and a possible pathophysiological mechanism is outlined. Treatment with perivascular sympathectomy and superior cervical ganglionectomy may be useful but more investigation needs to be carried out into the pathogenesis of the disease before more definitive therapy is realized.
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              Post-stroke movement disorders: report of 56 patients.

              G Dueñas, N Cevallos, Jan Zijlmans … (2004)
              Although movement disorders that occur following a stroke have long been recognised in short series of patients, their frequency and clinical and imaging features have not been reported in large series of patients with stroke. We reviewed consecutive patients with involuntary abnormal movements (IAMs) following a stroke who were included in the Eugenio Espejo Hospital Stroke Registry and they were followed up for at least one year after the onset of the IAM. We determined the clinical features, topographical correlations, and pathophysiological implications of the IAMs. Of 1500 patients with stroke 56 developed movement disorders up to one year after the stroke. Patients with chorea were older and the patients with dystonia were younger than the patients with other IAMs. In patients with isolated vascular lesions without IAMs, surface lesions prevailed but patients with deep vascular lesions showed a higher probability of developing abnormal movements. One year after onset of the IAMs, 12 patients (21.4%) completely improved their abnormal movements, 38 patients (67.8%) partially improved, four did not improve (7.1%), and two patients with chorea died. In the nested case-control analysis, the patients with IAMs displayed a higher frequency of deep lesions (63% v 33%; OR 3.38, 95% CI 1.64 to 6.99, p<0.001). Patients with deep haemorrhagic lesions showed a higher probability of developing IAMs (OR 4.8, 95% CI 0.8 to 36.6). Chorea is the commonest movement disorder following stroke and appears in older patients. Involuntary movements tend to persist despite the functional recovery of motor deficit. Deep vascular lesions are more frequent in patients with movement disorders.
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Mov Disord
                Journal ID (iso-abbrev): J Mov Disord
                Journal ID (publisher-id): JMD
                Title: Journal of Movement Disorders
                Publisher: The Korean Movement Disorders Society
                ISSN (Print): 2005-940X
                ISSN (Electronic): 2093-4939
                Publication date (Print): May 2016
                Publication date (Electronic): 25 May 2016
                Volume: 9
                Issue: 2
                Pages: 63-70
                Affiliations
                Department of Neurology, Korea University College of Medicine, Ansan Hospital, Ansan, Korea
                Author notes
                Corresponding author: Do-Young Kwon, MD, PhD, Department of Neurology, Korea University College of Medicine, Ansan Hospital, 123 Jeokgeum-ro, Danwon-gu, Ansan 15355, Korea Tel: +82-31-412-5150 Fax: +82-31-412-5154 E-mail: kwondoya@ 123456korea.ac.kr
                Article
                Publisher ID: jmd-16008
                DOI: 10.14802/jmd.16008
                PMC ID: 4886206
                PubMed ID: 27240807
                SO-VID: dd578513-bc7d-49b0-a027-b991baf9bc7c
                Copyright © Copyright © 2016 The Korean Movement Disorder Society
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 4 February 2016
                Date revision received : 23 February 2016
                Date accepted : 7 March 2016
                Categories
                Subject: Review Article

                Keywords: stroke,movement disorders,etiology,treatment,prognosis
                Data availability:
                Keywords: stroke, movement disorders, etiology, treatment, prognosis

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