Neuroimaging of Hemichorea-Hemiballism

J Korean Neurol Assoc > Volume 25(3); 2007 > Article

Journal of the Korean Neurological Association 2007;25(3): 318-323.

반무도병의 신경영상연구

이상훈, 안태범 부선희 김덕윤a

경희대학교 의과대학 신경과, 경희대학교 의과대학 핵의학과a

Neuroimaging of Hemichorea-Hemiballism

Sang Hun Yi

Department of Neurology, Kyung Hee University College of Medicine, Seoul, Korea; Department of Nuclear Medicine, Kyung Hee University College of Medicinea, Seoul, Korea

Abstract

Background: Hemichorea-Hemiballism (HCHB) can be caused by various diseases such as cerebrovascular disease, hyperglycemia, tumor, and inflammatory diseases. However, there are a few case studies using functional imaging such as single photon emission computed tomography (SPECT).
Methods: In this study, we included patients with HCHB. The patients with hyperglycemia over 250 mg/dl or high signal intensity on T1 weighted imaging were excluded. Clinical and neuroimaging characteristics of the patients were obtained and analyzed.
Results: We included 20 patients (M:F=12:8, mean age=67.1±15.3). Sixteen patients were presented with hemiballism and four with hemichorea. Six patients had no structural lesions causing HCHB. Subthalamic nucleus was the causative lesion in 6 patients. Other lesions associated with HCHB were basal ganglia, thalamus, and cortices. In a patient without structural lesion, anti-double stranded DNA antibody was detected. Brain SPECT showed not only perfusion abnormalities in the cases without structural lesions but also additional abnormalities in those with definite lesions.
Conclusions: Various mechanisms were related to the development of HCHB. Functional imaging such as SPECT and immunological work-up is needed to investigate the underlying pathomechanism of HCHB.KeyWords:Hemichorea, Hemiballism, Subthalamic nucleus, SPECT