Objective: To comprehensively examine the spectrum of post-stroke movement disorders (PSMDs), with a focus on understanding their prevalence, clinical characteristics, neuroanatomical correlates, and demographic profiles

Background: Movement disorders as a complication of stroke have been described variably in previous studies.(1) Uncertainties persist regarding the combined impact of age and stroke mechanism on the characteristics, onset, and outcomes of these abnormal movements.(2) Furthermore, PSMDs are generally considered rare, primarily affecting deep brain structures such as the basal ganglia and thalamus, although isolated case studies have reported movement disorders following strokes involving the cerebral cortex.(3)

Method: We conducted a systematic search of electronic databases (PubMed, Embase, and Cochrane Library) to identify relevant studies. Inclusion criteria inlcuded research articles, clinical trials, and observational studies focusing on PSMDs.

Results: Analysis of 576 cases revealed PSMDs were more common in elderly men and were predominantly preceded by ischemic strokes. The posterolateral thalamus was the most frequently affected region, with dystonia being the most common PSMD, followed by hemiballism and hemichorea. PSMDs varied by age group and stroke type, with dystonia more common in younger patients and chorea more prevalent in older individuals. Ischemic strokes were associated with parkinsonism, chorea, and dystonia, while hemorrhagic strokes were linked to dystonia, tremor, and myoclonus. Most PSMDs manifested early within the first 2 weeks of stroke, while some had a delayed onset progressive course. Over 70% of patients with PSMDs experienced spontaneous improvement or resolution, with myoclonus showing the highest rate of improvement and tremor the highest rate of persistence.

Conclusion: While many patients experience symptom resolution, the associated disability in terms of social, financial, and occupational burdens, coupled with the limited available therapies, emphasizes the critical importance of early recognition and management of post-stroke movement disorders. The current data primarily stem from individual case series and stroke registries, highlighting the necessity for additional robust research to guide clinical practice effectively.

References: (1) Ghika‑Schmid F, Ghika J, Regli F, Bogousslavsky J. Hyperkinetic movement disorders during and after acute stroke: The Lausanne Stroke Registry. J Neurol Sci 1997;146:109‑16
(2) Russmann H, Vingerhoets F, Ghika J, et al. Acute infarction limited to the lenticular nucleus: clinical, etiologic, and topographic features. Arch Neurol 2003;60:351-355.
(3) Alarcon F, Zijlmans JC, Duenas G, et al. Post-stroke movement disorders: report of 56 patients. J Neurol Neurosurg Psychiatry 2004;75:1568-1574.

« Back to 2024 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/post-stroke-movement-disorders-a-systematic-review-of-the-clinical-spectrum-neuroanatomy-and-demographic-characteristics-of-577-published-cases/