Background
Movement disorders occur in association with stroke and may have important clinical implications.
Methods
We reviewed the medical literature regarding the clinical phenomenology, prevalence, localization and etiologic implications, and treatments for movement disorders occurring after stroke in adult patients.
Results
Movement disorders occur uncommonly after stroke and include both hyperkinetic and parkinsonian conditions. They can occur at the time of stroke or appear as a later manifestation. Stroke lesions are typically due to small vessel cerebrovascular disease in the middle or posterior cerebral artery territory, vessels supplying the basal ganglia. Hemorrhagic lesions are more likely to induce hyperkinetic movements. Movement disorders in the setting of stroke tend to resolve spontaneously over time. Medical and surgical therapies are available to treat the movement problems.
Discussion
Movement disorders after stroke can be helpful in localizing lesions after stroke, determining the etiology of stroke, may need to be a target for therapy and may importantly influence long term outcome.
Estradiol and progesterone may influence disease activity in MS. If further studies confirm these results, it may be possible to develop therapy by altering levels of these hormones.
The prevalence of MS in India is low, and it is unclear whether the manifestations of the disease in India are similar to the United States. We carried out a case-control study to compare the disease in the two populations and used clinical, evoked potential, and MRI criteria to assess similarities and differences. Our results indicate that the rate of disease progression and frequency of involvement of the cerebral hemispheres, cerebellum, spinal cord, and brainstem were similar in the two populations. The visual system was more frequently involved in Indian patients. No Indian patient had a family history of MS; this suggests an environmental disease-triggering agent.
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