Hemiballism-Hemichorea Following Subthalamic Nucleus Hemorrhage

A 67-year-old man with untreated hypertension was admitted due to sudden onset involuntary movements involving the left arm and leg. Examination disclosed irregular coarse and twisting movement involving both distal and proximal muscles in the left arm and leg (Figure 1A). Magnetic resonance imaging and computed tomography of the brain revealed an acute hemorrhage in the right subthalamic nucleus (STN) (Figure 1BD). His hemiballismus-hemichorea improved within a few days following administration of risperidone 1 mg/day. However, after admission, the patient became restless, agitated and delirious and these symptoms were resolved by administration of haloperidol 3mg/day and tiapride 50mg/day.