Post-stroke Movement Disorders: The Clinical, Neuroanatomic, and Demographic Portrait of 284 Published Cases

Authors

Ritika Suri, James J. and Joan A. Gardner Center for Parkinson Disease and Movement Disorders, Department of Neurology and Rehabilitation Medicine, University of Cincinnati, Cincinnati, Ohio.Follow
Federico Rodriguez-Porcel, Department of Neurology, Medical University of South Carolina, Charleston, South Carolina.
Kelly Donohue, James J. and Joan A. Gardner Center for Parkinson Disease and Movement Disorders, Department of Neurology and Rehabilitation Medicine, University of Cincinnati, Cincinnati, Ohio.
Erin Jesse, Department of Chemistry, Ohio State University, Columbus, Ohio.
Lilia Lovera, Department of Neurology, Medical University of South Carolina, Charleston, South Carolina.
Alok Kumar Dwivedi, Department of Biomedical Sciences, Division of Biostatistics and Epidemiology, Texas Tech University Health Sciences Center El Paso, El Paso, Texas.
Alberto J. Espay, James J. and Joan A. Gardner Center for Parkinson Disease and Movement Disorders, Department of Neurology and Rehabilitation Medicine, University of Cincinnati, Cincinnati, Ohio. Electronic address: espayaj@ucmail.uc.edu.

Document Type

Article

Abstract

PURPOSE: Abnormal movements are a relatively uncommon complication of strokes. Besides the known correlation between stroke location and certain movement disorders, there remain uncertainties about the collective effects of age and stroke mechanism on phenomenology, onset latency, and outcome of abnormal movements. MATERIALS AND METHODS: We systematically reviewed all published cases and case series with adequate clinical-imaging correlations. A total of 284 cases were analyzed to evaluate the distribution of different movement disorders and their association with important cofactors. RESULTS: Posterolateral thalamus was the most common region affected (22.5%) and dystonia the most commonly reported movement disorder (23.2%). The most common disorders were parkinsonism (17.4%) and chorea (17.4%) after ischemic strokes and dystonia (45.5%) and tremor (19.7%) after hemorrhagic strokes. Strokes in the caudate and putamen were complicated by dystonia in one third of the cases; strokes in the globus pallidus were followed by parkinsonism in nearly 40%. Chorea was the earliest poststroke movement disorder, appearing within hours, whereas dystonia and tremor manifested several months after stroke. Hemorrhagic strokes were responsible for most delayed-onset movement disorders (>6 months) and were particularly overrepresented among younger individuals affected by dystonia. CONCLUSIONS: This evidence-mapping portrait of poststroke movement disorders will require validation or correction based on a prospective epidemiologic study. We hypothesize that selective network vulnerability and resilience may explain the differences observed in movement phenomenology and outcomes after stroke.

Medical Subject Headings

Humans; Movement Disorders (diagnostic imaging, epidemiology, etiology, physiopathology); Stroke (complications, diagnostic imaging, epidemiology, physiopathology)

Publication Date

9-1-2018

Publication Title

Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association

E-ISSN

1532-8511

Volume

27

Issue

9

First Page

2388

Last Page

2397

PubMed ID

29793802

Digital Object Identifier (DOI)

10.1016/j.jstrokecerebrovasdis.2018.04.028

Recommended Citation

Suri, Ritika; Rodriguez-Porcel, Federico; Donohue, Kelly; Jesse, Erin; Lovera, Lilia; Dwivedi, Alok Kumar; and Espay, Alberto J., "Post-stroke Movement Disorders: The Clinical, Neuroanatomic, and Demographic Portrait of 284 Published Cases" (2018). Neurology. 1685.
https://scholar.barrowneuro.org/neurology/1685