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Hemiballismus

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Hemiballismus is a type of movement disorder considered over a hundred times rarer compared to the more common Parkinson’s disease. People who are afflicted with Hemiballismus are subject to severe movement-related symptoms that render them unable to go about their day-to-day activities. This disease is linked to people who have suffered structural lesions in the brain, but it sometimes accompanies some metabolic abnormalities.

The frequent flinging movements of their arms and legs can identify people suffering from Hemiballismus. These random involuntary movements are vigorous, occur continuously, and can encompass all directions. Both the proximal and distal muscles of the body participate in this incessant movement, and in most cases, even a patient’s facial muscles exhibit involuntary muscle twitches.

HEMIBALLISMUS SIGNS AND SYMPTOMS

In mild forms of Hemiballismus, only a person’s arm or leg may be affected, rendering normal movements, such as walking, difficult. When the disease is more advanced, the body’s movements involve irregular and violent writhing, as well as muscle spasms on one or another side of the body. When even the muscles of the torso are affected, the whole body is subject to forceful and involuntary movements that last for up to several seconds at a time.

A patient who is awake and active will manifest an increasing number of these involuntary movements, and oftentimes, the arms and legs move together. However, with relaxation or sleep, these movements decrease considerably.

Hemiballismus is an ailment that can leave the patient both physically and mentally exhausted. Due to the violent motions involved, other injuries involving the joints and skin can occur. Hemiballismus is usually seen in people who are over 60 years old.

HEMIBALLISMUS CAUSES

One of the most common causes of Hemiballismus is an injury to the basal ganglia, an area of the brain responsible for controlling the body’s movement and balance. It can also be caused by the presence of abscesses or tumors in the brain, as well as malformed blood vessels, a severe trauma to the head, and even multiple sclerosis. In people younger than 60 years old, the disorder is likely caused by a brain inflammation or infection.

While Hemiballismus is an extremely rare disorder, it can also be the result of, or accompany a host of other injuries or ailments. It does not follow, however, that a patient suffering from any of these ailments and injuries will automatically develop Hemiballismus.

In a thousand people who have suffered a stroke, about 0.45 of them end up with Hemiballismus. Strokes are one of the most common causes of this movement disorder. Hemiballismus occurs when brain tissues die off from strokes that cause insufficient oxygen and lack of blood supply to the brain. This is particularly true if tissues in the basal ganglia are involved. The damaged basal ganglia, in turn, sends damaged electrical impulses to the body’s skeletal muscles, and the results conform to the symptoms of Hemiballismus.

When a person experiences a severe and traumatic brain injury, whether through an accident or an act of violence, portions of the brain that are attributed to motion can be affected. This can also lead to Hemiballismus movements in a patient. Hemiballismus can also be caused by amyotrophic lateral sclerosis. This disorder is responsible for gliosis and neuronal loss in the brain’s basal ganglia, thereby resulting in Hemiballismus.

HEMIBALLISMUS TREATMENT

When a patient suffering from nonketotic hyperglycemia develops the complication of a subthalamic nucleus lesion in the brain, Hemiballismus is one of the results. Brain lesions such as these are the second most common cause of the movement disorder, and they are often attributed to elderly patients of East Asian descent. This points toward a genetic factor involving the development of Hemiballismus symptoms in patients suffering from hyperglycemia. The symptoms become apparent whenever the blood glucose level of a patient soars, and this condition with its accompanying Hemiballismus symptoms can last for up to several hours.

Neoplasms, which are abnormal cell growths in the brain, can also lead to Hemiballismus, particularly if they form within the area of the basal ganglia. Malformed blood vessels, which act to impede normal blood flow to the brain, can also cause Hemiballismus. This is especially true if this vascular malformation leads up to the basal ganglia, in which there is a strong possibility of the patient having a stroke.

Patients suffering a tuberculous meningitis infection may have damaged parts of their basal ganglia, and can develop Hemiballismus as a result. Hemiballismus can also result from demyelinating plaques that injure the myelin sheaths found in the brain’s neurons. This impedes neuron conduction, and garbles the signals they send to the basal ganglia. The garbled signals result in uncoordinated and involuntary body movements.

As part of the complications arising from HIV infections, Hemiballismus may arise in patients due to hypoglycemia stemming from their use of pentamidine. It can also be the cause of cerebral toxoplasmosis, a secondary infection resulting from an impaired immune system, characteristic of persons suffering from HIV. In most cases, Hemiballismus may be one of the visible manifestations from which a doctor can determine that a patient has AIDS.

HEMIBALLISMUS DIAGNOSIS

To make an accurate diagnosis, the doctor will take down a patient’s complete medical history to ascertain the existence of a past brain or nervous system injury. The doctor will also perform a thorough physical examination, taking into account the patient’s age, drug history, and symptoms in order to rule out other movement disorders that may be similar to Hemiballismus.


The patient will be put through a series of basic movements, and the doctor will observe the number of Hemiballistic movements that occur within a given time period. This will enable the doctor to rate the severity of the patient’s symptoms in order to prescribe appropriate medication and therapy.

In treating Hemiballismus, it is important to first treat the underlying ailment or injury that has caused or accompanied it, whether the ailment is a stroke, hyperglycemia, brain lesions, or infections. In some cases, Hemiballismus symptoms may be mild, and treatment can be limited to the underlying causes of the disorder. There are many types of medications used to treat Hemiballismus. One of these is dopamine blockers, which have been found to be 90% effective in treating symptoms of the disorder. An anticonvulsant known as topiramate has also been successful in treating Hemiballismus cases.

Other solutions include ITB therapy involving an implanted ITB pump to decrease Hemiballismus episodes, botulinum injections, administration of tetrabenazine, and the antipsychotic drug haloperidol. In severe cases of Hemiballismus that do not respond to traditional treatment, neurosurgical procedures for lesioning the brain’s globus pallidus or to undertake deep brain stimulation are other viable options.

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