Abstract
Mukand JA, Fitzsimmons C, Wennemer HK, Carrillo A, Cai C, Bailey KM. Olanzapine for
the treatment of hemiballismus: a case report.
Hemiballismus is a rare movement disorder characterized by involuntary, large amplitude
movements of the limbs of 1 side of the body. We describe the case of a man in his
late sixties with slurred speech, agitation, and right-sided hemiballismus resulting
from a left thalamic hemorrhagic stroke. Treatment with haloperidol was unsuccessful,
but both the hemiballismus and agitation diminished significantly after initiation
of olanzapine (Zyprexa). The improvement in the hemiballismus was quantified by recording
the number of hemiballistic movements that occurred while the patient performed standardized
30-minute sessions (daily for 5d). With the first task (reaching within the base of
support while seated), the average number of hemiballismic movements per session decreased
from a baseline of 23.5 to 3.0 in the upper extremity and from 20.5 to 7.0 in the
lower extremity. With the second task (catching a ball while seated), the abnormal
movements decreased from 52 to 6.3 in the upper extremity and from 34.5 to 2.7 in
the lower extremity. This case suggests that olanzapine may be a valuable pharmacologic
alternative for patients with hemiballismus.
Key words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Archives of Physical Medicine and RehabilitationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Treatment and prognosis of hemiballismus.N Engl J Med. 1976; 295: 1348-1350
- Studies on subthalamus of rhesus monkey: hyperkinesia and other physiologic effects of subthalamic lesions, with special reference to the subthalamic nucleus of Luys.J Comp Neurol. 1949; 90: 319-372
- Hemichorea resulting from a local lesion of the brain (the syndrome of the body of Luys).Brain. 1927; 50: 637-651
- Movement disorders and AIDS.Neurology. 1987; 37: 37-41
- Hemiballismus-hemichorea: clinical and pharmacologic findings in 21 patients.Arch Neurol. 1989; 46: 862-867
- Postsynaptic integration of glutaminergic and dopaminergic signals in the striatum.Prog Neurobiol. 1994; 44: 163-196
- Hemiballismus.Am J Neuroradiol. 1994; 15: 1377-1382
- Physiological bases of involuntary movement.Neurology. 1994; 34: 1241-1242
- Interactions between glutaminergic and monoaminergic systems within the basal ganglia.Trends Neurosci. 1990; 13: 272-276
- Hemiballismus in systemic lupus erythematosus: possible association with antiphospholipid antibodies.Lupus. 1995; 4: 67-69
- Hemiballismus as a presenting sign of hyperglycemia.Am J Emerg Med. 1995; 13: 647-648
- Hemiballismus.Clin Neuropharmacol. 1990; 13: 413-425
- Hemiballismus following closed head injury.Brain Inj. 1996; 10: 155-158
- Hemichorea-hemiballism caused by arteriovenous malformation in the putamen.J Neurol. 1987; 234: 124-125
- Hemiballismus and metastatic brain tumor.Neurol. 1984; 34: 204-207
- Treatment of vascular hemiballism and hemichorea.Neurology. 1977; 27: 634-636
- Long-term prognosis of vascular hemiballismus.Stroke. 2002; 33: 2109-2115
- Clozapine for the control of hemiballismus.Clin Neuropharmacol. 1994; 17: 477-480
- Response of hemiballismus to haloperidol.JAMA. 1975; 233: 535-536
- Hemiballismus treated with sodium valproate.BMJ. 1981; 283: 17-18
- Amelioration of hemiballismus with sodium valproate.Ann Neurol. 1982; 12: 407-411
- Successful treatment of hemiballismus with progabide, a new GABA-mimetic agent.J Neurol. 1983; 229: 121-124
- Risperidone is effective in severe hemichorea/hemiballismus.Mov Disord. 1999; 14: 377-379
- Reversal of hemiballismus by tetrabenazine.JAMA. 1972; 219: 1345-1347
- Outcome after stereotactic thalamotomy for dystonia and hemiballismus.Neurosurgery. 1995; 36: 501-508
- Acute hemiballismus treated by ventrolateral thalamolysis.Brain. 1959; 82: 104-108
- The effect of novel antipsychotics in rat oral dyskinesia.Prog Neuropsychopharmacol Biol Psychiatry. 1999; 23: 1389-1404
- Clozapine versus placebo in Huntington’s disease: a double blind randomised comparative study.J Neurol Neurosurg Psychiatry. 1997; 63: 35-39
- The treatment of tardive dyskinesia and tardive dystonia.J Clin Psychiatry. 2000; 61: 39-44
- Olanzapine in Tourette’s disorder.J Am Acad Child Adolesc Psychiatry. 2000; 39: 140-143
- Olanzapine improves chorea in patients with Huntington’s disease.Rev Neurol. 2002; 35: 524-525
- The use of olanzapine for movement disorder in Huntington’s disease: a first case report.J Neurol Neurosurg Psychiatry. 1999; 67: 123-124
- Treatment of patients with tardive dystonia with olanzapine.Clin Neuropharmacol. 2002; 25: 71-74
- In vitro and in vivo biochemistry of olanzapine: a novel antipsychotic drug.J Clin Psychiatry. 1997; 58: 28-36
- Adverse events related to olanzapine.J Clin Psychiatry. 2000; 61: 26-29
- Clozapine-induced agranulocytosis: Incidence and risk factors in the United States.N Engl J Med. 1993; 329: 162-167
- Olanzapine-induced agranulocytosis: a case report and review of literature.Prog Neuropsychopharmacol Biol Psychiatry. 2002; 26: 411-414
Article info
Publication history
Accepted:
May 24,
2004
Footnotes
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors(s) or upon any organization with which the author(s) is/are associated.
Identification
Copyright
© 2005 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.