Dual Treatment of Hemichorea–Hemiballismus Syndrome with Tetrabenazine and Chemodenervation

BACKGROUND Hemichorea-hemiballismus involves unilateral involuntary flailing movements and random jerking movements involving proximal or distal muscles. We describe a case of hemichorea-hemiballismus with dystonia after stroke. Treatment with tetrabenazine and chemodenervation produced beneficial responses. Effective treatment of both hemichorea-hemiballismus and dystonia due to stroke has not been reported. CASE REPORT A 65-year-old male developed left hemichorea-hemiballismus and dystonia after a right hemisphere stroke. He underwent initial treatment with neuroleptics and anticonvulsants without improvement. Subsequent treatment with tetrabenazine improved the hemichorea-hemiballismus and chemodenervation reduced the dystonia. DISCUSSION Hemichorea-hemiballismus associated with dystonia can be improved with both tetrabenazine and chemodenervation.