Objective: Describe an unsual cause of movements disorders .

Background: Hemiballismus-hemichorea is a rare and debilitating presentation of subcortical stroke.

Method: We describe a case a 70-year-old smoking, diabetic and hypertensive man. He presented to our emergency department following 72 hours history of involuntary left upper- and lower-limb movements. There was a history of transient stroke 3months ago. Our patient had no other clinical manifestations or family history to suggest Huntington’s disease, no recent traumatic head injuries and was not on anti-seizure medications or any anti-psychotic. His neurological examination was notable for left-sided periodic ballistic and choreiform movements, which improved during sleep. brain imaging showed multiple lacunar subcortical stroke. Blood investigations showed high blood sugar levels and high level of blood cholesterol.

Results: Aspirin, Clopidogrel, Metformin and Atorvastatin were prescribed for the management of lacunar stroke. hemiballismus hemichorea movement reduced markedly within 2 weeks of starting the treatment and the patient was kept on regular home and outpatient follow up for further monitoring.

Conclusion: We have presented this case as an uncommon complication of comorbid conditions; we need to investigate the etiology of movement disorders from other etiology of ischemic stroke subtypes which have a different treatment approach and outcome.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/hemiballismus-hemichorea-due-to-ischemic-stroke/