Document Detail


Post-stroke movement disorders: report of 56 patients.
MedLine Citation:
PMID:  15489389     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: 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. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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.
Authors:
F Alarcón; J C M Zijlmans; G Dueñas; N Cevallos
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of neurology, neurosurgery, and psychiatry     Volume:  75     ISSN:  0022-3050     ISO Abbreviation:  J. Neurol. Neurosurg. Psychiatr.     Publication Date:  2004 Nov 
Date Detail:
Created Date:  2004-10-18     Completed Date:  2004-12-02     Revised Date:  2010-09-20    
Medline Journal Info:
Nlm Unique ID:  2985191R     Medline TA:  J Neurol Neurosurg Psychiatry     Country:  England    
Other Details:
Languages:  eng     Pagination:  1568-74     Citation Subset:  IM    
Affiliation:
Department of Neurology, Eugenio Espejo Hospital, PO Box 17-07-9515, Quito, Ecuador, South America. alyosha@access.net.ec
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Age Factors
Aged
Brain / physiopathology,  radiography
Case-Control Studies
Cerebral Infarction / complications*,  mortality,  physiopathology,  radiography
Chorea / etiology,  mortality,  physiopathology,  radiography
Dominance, Cerebral / physiology
Dyskinesias / etiology*,  mortality,  physiopathology,  radiography
Dystonia / etiology,  mortality,  physiopathology,  radiography
Female
Follow-Up Studies
Humans
Intracranial Hemorrhages / complications*,  mortality,  physiopathology,  radiography
Male
Middle Aged
Neurologic Examination
Parkinsonian Disorders / etiology,  mortality,  physiopathology,  radiography
Probability
Prognosis
Registries
Risk Factors
Subarachnoid Hemorrhage / complications,  mortality,  physiopathology,  radiography
Survival Analysis
Tomography, X-Ray Computed
Tremor / etiology,  mortality,  physiopathology,  radiography
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