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.