Turkish Journal of Physical Medicine and Rehabilitation 2024 , Vol 70 , Num 3

Effect of low-frequency repetitive magnetic transcranial stimulation in hemichorea-hemiballismus with ipsilateral basal ganglia hemorrhage: A case report

Kim Heejae 1
1 Department of Rehabilitation Medicine, Shihwa Medical Center, Gyeonggi-do, Republic of Korea DOI : 10.5606/tftrd.2024.13022 Post-stroke hemichorea-hemiballismus (HCHB) typically manifests as hyperkinetic movements contralateral to the lesion, but rarely occurs ipsilaterally. In this article, we present a rare case who initially presented with left hemiparesis and developed right HCHB after right basal ganglia hemorrhage. To facilitate motor recovery in the left hemiparesis, we applied low-frequency repetitive transcranial magnetic stimulation (rTMS) over the left primary motor cortex. Unexpectedly, the right HCHB was significantly reduced after four weeks of therapy. Post-treatment perfusion imaging showed increased cerebral blood flow in the left middle cerebral artery territory. In conclusion, low-frequency rTMS may be considered an alternative therapy for post-stroke HCHB. Keywords : Basal ganglia, chorea, dyskinesias, movement disorders, stroke, transcranial magnetic stimulation