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Survival Tips
Published in John Larkin, 101 Top Tips in Medicine, 2021
Other times when you should be careful not to let the patient damage you include: Checking power grip in the hands – always give them two fingers to crunch, as they can severely damage either one or three.Examining a gouty joint in an extremity – my colleague was kicked in the face last week whilst examining a podagra53 in a slightly histrionic patient who liked to emphasise their pain with a bit of drama.Examining anything in a slightly histrionic patient who likes to emphasise their pain with a bit of drama.Taking blood from a patient with hemiballismus.54
Hemiballismus
Published in K. Gupta, P. Carmichael, A. Zumla, 100 Short Cases for the MRCP, 2020
K. Gupta, P. Carmichael, A. Zumla
Hemiballismus is characterized by forceful, flinging and violent movements of mainly the proximal parts of the limbs of one half of the body. The movements disappear during sleep. The most common aetiology is that of a vascular event in the contralateral subthalamic nucleus; other causes include an expanding AV malformation, trauma, tumour and multiple sclerosis. In cases of intractable involuntary movements, surgery may be indicated.
Key terms
Published in Vivian A. Elwell, Ramez Kirollos, Syed Al-Haddad, Neurosurgery, 2014
Vivian A. Elwell, Ramez Kirollos, Syed Al-Haddad
Hemiballismus – a unilateral wild, large-amplitude flinging involuntary movement of the proximal part of the limbs, which results in postural imbalance. It is caused by a decrease in activity of the subthalamic nucleus of the basal ganglia.
Treatment options for chorea
Published in Expert Review of Neurotherapeutics, 2018
Chorea is a hyperkinetic movement disorder consisting of abrupt, irregular, random, jerk-like movements that can affect any part of the body [1]. The term athetosis is used to describe a slow form of chorea manifested by writhing movements predominantly involving distal parts of extremities. Sometimes it is considered a form of dystonia as some patients with acute hemichorea evolve into hemiathetosis and then to hemidystonia [2]. Ballism typically consists of high amplitude, flinging movements of proximal limbs and may affect only one side of the body (hemiballism). Indeed, all three movements may be found in a single patient, for example after a stroke involving the subthalamic nucleus, starting with ballism and evolving into chorea or athetosis.