Skip to main content Accessibility help
  • Print publication year: 2014
  • Online publication date: April 2014

Chapter 17 - Movement disorders in stroke

from Section IV - Movement disorders in general neurology



Stroke is the second leading cause of death in industrialized nations and the most important cause of permanent neurological disability in the elderly. According to recent WHO estimates, stroke ranks second after dementia in the overall burden of disease from brain disorders and accounts for about 4.1 percent of all cause burden of disease (Murray et al. 2012). Prevalence of stroke rises with advancing age and beyond the age of 70 annual stroke incidence rises to above 2,000 per 100,000 (Diaz-Guzman et al. 2012; Kissela et al. 2012; Khellaf et al. 2010; Warlow et al. 2003). Approximately 85 percent of all strokes are ischemic in nature, while 15 percent result from intracerebral hemorrhage. Arteriosclerosis is the single most important cause of ischemic stroke, either via large or small vessel disease or combinations followed by embolic stroke from cardiac sources. Stroke symptoms depend on the anatomic location of brain infarcts or hemorrhages and the functional connectivity of lesion sites. Involvement of the basal ganglia and their afferent and efferent connections is very common in strokes affecting the middle cerebral artery territory, and yet movement disorders seem to be relatively rarely reported in the context of stroke. This may be partially due to observer bias with focus on acute stroke symptoms and acute management, while in many cases movement disorders only develop after acute stroke symptoms have resolved. Also, the distinction between vascular “look-alikes” of common degenerative movement disorders and their bona fide counterparts can be challenging, as probably best exemplified by the controversies and uncertainties related to vascular parkinsonism.

Mechanisms underlying stroke-related movement disorders

Dysfunctional sensorimotor integration is the common final pathophysiological pathway for all movement disorders and the neural networks involved include motor loops interconnecting the cerebellum, brainstem nuclei, basal ganglia, thalamus, and motor and pre-motor cortical areas (Abbruzzese and Berardelli 2003).

Abbruzzese, G. and Berardelli, A. (2003). “Sensorimotor integration in movement disorders,” Mov. Disord. 18: 231–40.
Alarcón, F., Zijlmans, J. C., Dueñas, G., and Cevallos, N. (2004). “Post-stroke movement disorders: report of 56 patients,” J. Neurol. Neurosurg. Psychiatry 75: 1568–74.
Albanese, A., Bhatia, K., Bressman, S., Delong, M. R., Fahn, S., Fung, V. S., et al. (2013). “Phenomenology and classification of dystonia: a consensus update,” Mov. Disord. [E-pub. ahead of print] .
Alexander, G. E., DeLong, M. R., and Strick, P. L. (1986). “Parallel organization of functionally segregated circuits linking basal ganglia and cortex,” Ann. Rev. Neurosci. 9: 357–81.
Altafullah, I., Pascual-Leone, A., Duvall, K., Anderson, D. C., and Taylor, S. (1990). “Putaminal hemorrhage accompanied by hemichorea-hemiballism,” Stroke 21: 1093–4.
Astradsson, A., Schweder, P., Joint, C., Forrow, B., Thevathasan, W., Pereira, E., et al. (2010). “Thalamotomy for postapoplectic hemiballistic chorea in older adults,” J. Am. Geriatr. Soc. 58: 2240–1.
Bähr, M., Frotscher, M., and Duus, P. (2009). Neurologisch-topische Diagnostik: Anatomie – Funktion –Klinik (Stuttgart: Thieme).
Bandt, S. K., Anderson, D., and Biller, J. (2008). “Deep brain stimulation as an effective treatment option for post-midbrain infarction-related tremor as it presents with Benedikt syndrome,” J. Neurosurg. 109: 635–9.
Barbaud, A., Hadjout, K., Blard, J. M., and Pages, M. (2001). “Improvement in essential tremor after pure sensory stroke due to thalamic infarction,” Eur. Neurol. 46: 57–9.
Barinagarrementeria, F., Vega, F., and DelBrutto, O. H. (1989). “Acute hemichorea due to infarction in the corona radiata,” J. Neurol. 236: 371–2.
Baumgartner, R. W. and Baumgartner, I. (1998). “Vasomotor reactivity is exhausted in transient ischaemic attacks with limb shaking,” J. Neurol. Neurosurg. Psychiatry 65(4): 561–4.
Baysal, L., Acarer, A., and Celebisoy, N. (2009). “Post-ischemic Holmes’ tremor of the lower extremities,” J. Neurol. 256: 2079–81.
Bhatia, K. P. and Marsden, C. D. (1994). “The behavioural and motor consequences of focal lesions of the basal ganglia in man,” Brain 117(Pt. 4): 859–76.
Blakeley, J. and Jankovic, J. (2002). “Secondary causes of paroxysmal dyskinesia,” Adv. Neurol. 89: 401–20.
Braga-Neto, P., Santos-Neto, D., Kuster, G. W., Silva, G. S., Vieira, V. L., Borges, V., et al. (2008). “Dystonia as a first presentation of cryptogenic stroke in a young patient with right-to-left shunt,” Mov. Disord. 23: 626–8.
Camac, A., Greene, P., and Khandji, A. (1990). “Paroxysmal kinesigenic dystonic choreoathetosis associated with a thalamic infarct,” Mov. Disord. 5: 235–8.
Cardoso, F., Seppi, K., Mair, K. J., Wenning, G. K., and Poewe, W. (2006). “Seminar on choreas,” Lancet Neurol. 5: 589–602.
Cho, C. and Samkoff, L. M. (2000). “A lesion of the anterior thalamus producing dystonic tremor of the hand,” Arch. Neurol. 57: 1353–5.
Choi, S. J., Lee, S. W., Kim, M. C., Kwon, J. Y., Park, C. K., Sung, J. H., et al. (2003). “Posteroventral pallidotomy in medically intractable postapoplectic monochorea: case report,” Surg. Neurol. 59: 486–90.
Chuang, C., Fahn, S., and Frucht, S. J. (2002). “The natural history and treatment of acquired hemidystonia: report of 33 cases and review of the literature,” J. Neurol. Neurosurg. Psychiatry 72: 59–67.
Chung, S. J., Im, J. H., Lee, M. C., and Kim, J. S. (2004). “Hemichorea after stroke: clinical-radiological correlation,” J. Neurol. 251: 725–9.
Comella, C. (2008). “General management approach to dystonia,” in Hallett, M. and Poewe, W. (eds.), Therapeutics of Parkinson’s Disease and Other Movement Disorders (Oxford: Wiley-Blackwell), pp. 217–26.
Crozier, S., Lehéricy, S., Verstichel, P., Masscon, C., and Masson, M. (1996). “Transient hemiballism/hemichorea due to an ipsilateral subthalamic nucleus infarction,” Neurology 46(1): 267–8.
DeLong, M. R. and Wichmann, T. (2007). “Circuits and circuit disorders of the basal ganglia,” Arch. Neurol. 64: 20–4.
Dethy, S., Luxen, A., Bidaut, L. M., and Goldman, S. (1993). “Hemibody tremor related to stroke,” Stroke 24: 2094–6.
Deuschl, G. (2008). Other Tremor Disorders. Therapeutics of Parkinson’s Disease and Other Movement Disorders (Oxford: Wiley-Blackwell).
Deuschl, G., Bain, P., and Brin, M. (1998a). “Consensus statement of the Movement Disorder Society on Tremor. Ad Hoc Scientific Committee,” Mov. Disord. 13(Suppl. 3): 2–23.
Deuschl, G. and Bergman, H. (2002). “Pathophysiology of nonparkinsonian tremors,” Mov. Disord. 17(Suppl. 3): S41–8.
Deuschl, G., Koster, B., Lucking, C. H., and Scheidt, C. (1998b). “Diagnostic and pathophysiological aspects of psychogenic tremors,” Mov. Disord. 13: 294–302.
Deuschl, G. and Lucking, C. H. (1990). “Physiology and clinical applications of hand muscle reflexes,” Electroencephalogr. Clin. Neurophysiol. Suppl. 41: 84–101.
Deuschl, G., Toro, C., Valls-Sole, J., Zeffiro, T., Zee, D. S., and Hallett, M. (1994). “Symptomatic and essential palatal tremor. 1. Clinical, physiological and MRI analysis,” Brain 117(Pt. 4): 775–88.
Di Lazzaro, L., Pilato, F., Saturno, E., Dileone, M., Tonali, P. A., Antonelli, M., et al. (2005). “Bilateral chorea-ballism after cardiac arrest,” Neurology 64: E20.
Diaz-Guzman, J., Egido, J. A., Gabriel-Sanchez, R., Barbera-Comes, G., Fuentes-Gimeno, B., and Fernandez-Perez, C. (2012). “Stroke and transient ischemic attack incidence rate in Spain: the IBERICTUS study,” Cerebrovasc. Dis. 34: 272–81.
Driver-Dunckley, E. and Evidente, V. G. (2005). “Hemichorea-hemiballismus may respond to topiramate,” Clin. Neuropharmacol. 28: 142–4.
Dubinsky, R. M. and Jankovic, J. (1987). “Progressive supranuclear palsy and a multi-infarct state,” Neurology 37: 570–6.
Fahn, S. (1988). “Concept and classification of dystonia,” Adv. Neurol. 50: 1–8.
Fisher, C. M. (1962). “Concerning recurrent transient cerebral ischemic attacks,” Can. Med. Assoc. J. 86(24): 1091–9.
FitzGerald, P. M. and Jankovic, J. (1989). “Lower body parkinsonism: evidence for vascular etiology,” Mov. Disord. 4: 249–60.
Franzini, A., Messina, G., Marras, C., Molteni, F., Cordella, R., Soliveri, P., et al. (2009). “Poststroke fixed dystonia of the foot relieved by chronic stimulation of the posterior limb of the internal capsule,” J. Neurosurg. 111: 1216–19.
Fukui, T., Hasegawa, Y., Seriyama, S., Takeuchi, T., Sugita, K., and Tsukagoshi, H. (1993). “Hemiballism-hemichorea induced by subcortical ischemia,” Can. J. Neurol. Sci. 20: 324–8.
Gatto, E. M., Uribe, R. C., Raina, G., Gorja, M., Folgar, S., and Micheli, F. E. (2004). “Vascular hemichorea/hemiballism and topiramate,” Mov. Disord. 19: 836–8.
Gerschlager, W., Bencsits, G., Pirker, W., Bloem, B. R., Asenbaum, S., Prayer, D., et al. (2002). “[123I]beta-CIT SPECT distinguishes vascular parkinsonism from Parkinson’s disease,” Mov. Disord. 17: 518–23.
Ghika, J., Bogousslavsky, J., Henderson, J., Maeder, P., and Regli, F. (1994). “The ‘jerky dystonic unsteady hand’: a delayed motor syndrome in posterior thalamic infarctions,” J. Neurol. 241: 537–42.
Ghika, J., Ghika-Schmid, F., and Bogousslasvky, J. (1998). “Parietal motor syndrome: a clinical description in 32 patients in the acute phase of pure parietal strokes studied prospectively,” Clin. Neurol. Neurosurg. 100: 271–82.
Ghika-Schmid, F., Ghika, J., Regli, F., and Bogousslavsky, J. (1997). “Hyperkinetic movement disorders during and after acute stroke: the Lausanne Stroke Registry,” J. Neurol. Sci. 146: 109–16.
Gibb, W. R. and Lees, A. J. (1988). “A comparison of clinical and pathological features of young- and old-onset Parkinson’s disease,” Neurology 38: 1402–6.
Gonzalez-Alegre, P., Ammache, Z., Davis, P. H., and Rodnitzky, R. L. (2003). “Moyamoya-induced paroxysmal dyskinesia,” Mov. Disord. 18: 1051–6.
Guberman, A. and Stuss, D. (1983). “The syndrome of bilateral paramedian thalamic infarction,” Neurology 33: 540–6.
Hallett, M. (1995). “Is dystonia a sensory disorder?Ann. Neurol. 38: 139–40.
Hammond, W. A. (1871). A Treatise on Disease of the Nervous System (New York: Appleton & Co.), pp. 655–62.
Hashimoto, T., Morita, H., Tada, T., Maruyama, T., Yamada, Y., and Ikeda, S. (2001). “Neuronal activity in the globus pallidus in chorea caused by striatal lacunar infarction,” Ann. Neurol. 50: 528–31.
Hughes, A. J., Daniel, S. E., Kilford, L., and Lees, A. J. (1992). “Accuracy of clinical diagnosis of idiopathic Parkinson’s disease: a clinico-pathological study of 100 cases,” J. Neurol. Neurosurg. Psychiatry 55: 181–4.
Inzelberg, R., Bornstein, N. M., Reider, I., and Korczyn, A. D. (1994). “Basal ganglia lacunes and parkinsonism,” Neuroepidemiology 13: 108–12.
Irioka, T., Ayabe, J., and Mizusawa, H. (2010). “Hemichorea improved by extracranial-intracranial bypass surgery for middle cerebral artery occlusion,” J. Neurol. 257: 1756–8.
Jankovic, J. (1986). “Blepharospasm with basal ganglia lesions,” Arch. Neurol. 43: 866–8.
Jankovic, J. and Clarence-Smith, K. (2011). “Tetrabenazine for the treatment of chorea and other hyperkinetic movement disorders,” Expert Rev. Neurother. 11: 1509–23.
Jankovic, J. and Patel, S. C. (1983). “Blepharospasm associated with brainstem lesions,” Neurology 33: 1237–40.
Josephs, K. A., Ishizawa, T., Tsuboi, Y., Cockson, N., and Dickson, D. W. (2002). “A clinicopathological study of vascular progressive supranuclear palsy: a multi-infarct disorder presenting as progressive supranuclear palsy,” Arch. Neurol. 59(10): 1597–601.
Katzenschlager, R., Manson, A. J., Evans, A., Watt, H., and Lees, A. J. (2004). “Low dose quetiapine for drug induced dyskinesias in Parkinson’s disease: a double blind cross over study,” J. Neurol. Neurosurg. Psychiatry 75: 295–7.
Khellaf, M., Quantin, C., d’Athis, P., Fassa, M., Jooste, V., Hervieu, M., et al. (2010). “Age-period-cohort analysis of stroke incidence in Dijon from 1985 to 2005,” Stroke 41: 2762–7.
Kim, H. J., Cho, Y. J., Cho, J. Y., Hong, K. S., and Jeon, B. S. (2008). “Choreodystonia in a patient with hypertrophic olivary degeneration after pontine tegmental hemorrhage,” Mov. Disord. 23: 920–2.
Kim, J. S. (2001). “Delayed onset mixed involuntary movements after thalamic stroke: clinical, radiological and pathophysiological findings,” Brain 124: 299–309.
Kim, J. S., Lee, K. S., Lee, K. H., Kim, Y. I., Kim, B. S., Chung, Y. A., et al. (2002). “Evidence of thalamic disinhibition in patients with hemichorea: semiquantitative analysis using SPECT,” J. Neurol. Neurosurg. Psychiatry 72: 329–33.
Kim, J. S. and Lee, M. C. (1994). “Writing tremor after discrete cortical infarction,” Stroke 25: 2280–2.
Kim, J. S. and Suh, D. C. (2001). “Hemiballism-hemichorea and posterior communicating artery stenosis,” Eur. Neurol. 45: 182–3.
Kim, Y. H., Leitch, J. W., Klein, G. J., Yee, R., and Leather, R. A. (1992). “Effect of atropine and isoproterenol on tachycardia induction in asymptomatic patients with Wolff-Parkinson-White electrocardiographic pattern,” Can. J. Cardiol. 8: 716–20.
Kissela, B. M., Khoury, J. C., Alwell, K., Moomaw, C. J., Woo, D., Adeoye, O., et al. (2012). “Age at stroke: temporal trends in stroke incidence in a large, biracial population,” Neurology 79: 1781–7.
Knoflach, M., Matosevic, B., Meinhart, M., Rücker, M., Furtner, M., Zangerle, A., et al. (2011). “Prognostic relevance of limb shaking in symptomatic carotid artery occlusion,” Cerebrovasc. Dis. 32: 35–40.
Kopell, B. H., Rezai, A. R., Chang, J. W., and Vitek, J. L. (2006). “Anatomy and physiology of the basal ganglia: implications for deep brain stimulation for Parkinson’s disease,” Mov. Disord. 21(Suppl. 14): S238–46.
Kudo, M., Goto, S., Nishikawa, S., Hamasaki, T., Soyama, N., Ushio, Y., et al. (2001). “Bilateral thalamic stimulation for Holmes’ tremor caused by unilateral brainstem lesion,” Mov. Disord. 16: 170–4.
Kwak, C. H. and Jankovic, J. (2002). “Tourettism and dystonia after subcortical stroke,” Mov. Disord. 17: 821–5.
LeDoux, M. S. and Brady, K. A. (2003). “Secondary cervical dystonia associated with structural lesions of the central nervous system,” Mov. Disord. 18: 60–9.
Lee, M. S., Kim, Y. D., Yang, J. W., Lyoo, C. H., Oh, S. H., and Kim, H. S. (2001a). “Clinical and anatomical factors associated with thalamic dyskinesias,” J. Neurol. Sci. 182: 137–42.
Lee, M. S., Kim, Y. D., Yang, J. W., Lyoo, C. H., Oh, S. H., and Kim, H. S. (2001b). “Clinical and anatomical factors associated with thalamic dyskinesias,” J. Neurol. Sci. 182: 137–42.
Lee, M. S. and Marsden, C. D. (1994). “Movement disorders following lesions of the thalamus or subthalamic region,” Mov. Disord. 9: 493–507.
Lehericy, S., Grand, S., Pollak, P., et al. (2001). “Clinical characteristics and topography of lesions in movement disorders due to thalamic lesions,” Neurology 57: 1055–66.
Leira, E. C., Ajax, T., and Adams, H. P. (1997). “Limb-shaking carotid transient ischemic attacks successfully treated with modification of the antihypertensive regimen,” Arch. Neurol. 54: 904–5.
Lim, D. A., Khandhar, S. M., Heath, S., Ostrem, J. L., Ringel, N., and Starr, P. (2007). “Multiple target deep brain stimulation for multiple sclerosis related and poststroke Holmes’ tremor,” Stereotact. Funct. Neurosurg. 85: 144–9.
Louis, E. D., Lynch, T., Ford, B., Greene, P., Bressman, S. B., and Fahn, S. (1996). “Delayed-onset cerebellar syndrome,” Arch. Neurol. 53: 450–4.
Critchley, M. (1929). “Arteriosclerotic Parkinsonism,” Brain 52(1): 23–83.
Marsden, C. D., Obeso, J. A., Zarranz, J. J., and Lang, A. E. (1985). “The anatomical basis of symptomatic hemidystonia,” Brain 108(Pt. 2): 463–83.
Mehanna, R. and Jankovic, J. (2013). “Movement disorders in cerebrovascular disease,” Lancet Neurol. 12(6): 597–608.
Mink, J. W. (2003). “The basal ganglia and involuntary movements: impaired inhibition of competing motor patterns,” Arch. Neurol. 60: 1365–8.
Miwa, H., Hatori, K., Kondo, T., Imai, H., and Mizuno, Y. (1996). “Thalamic tremor: case reports and implications of the tremor-generating mechanism,” Neurology 46: 75–9.
Moro, E., Lang, A. E., Strafella, A. P., Poon, Y. Y., Arango, P. M., Dagher, A., et al. (2004). “Bilateral globus pallidus stimulation for Huntington’s disease,” Ann. Neurol. 56: 290–4.
Moroo, I., Hirayama, K., and Nakajima, M. (1997). “Delayed onset postural tremor caused by parietal lesion,” Mov. Disord. 12: 1098–100.
Murray, C. J. L., Vos, T., Lozano, R., Naghavi, M., Flaxman, A. D., Michaud, C., et al. (2012). “Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010,” Lancet Neurol. 380: 2197–223.
O’Suilleabhain, P. and Dewey, R. B. (2003). “A randomized trial of amantadine in Huntington disease,” Arch. Neurol. 60: 996–8.
Obeso, J. A., Rodriguez-Oroz, M. C., Rodriguez, M., Arbizu, J., and Gimenez-Amaya, J. M. (2002). “The basal ganglia and disorders of movement: pathophysiological mechanisms,” News Physiol. Sci. 17: 51–5.
Ondo, W. G., Chan, L. L., and Levy, J. K. (2002). “Vascular parkinsonism: clinical correlates predicting motor improvement after lumbar puncture,” Mov. Disord. 17: 91–7.
Oppenheim, H. (1911). “Uber Eine eigenartige Kramotkrankheit des Kindlichen und jugendlichen Alters (Dysbasia lordotica progressiva, Dystonia musculorum deformans),” Neurologie Centralblatt 30: 1090–107.
Otto, S., Buttner, T., Schols, L., Windmeier, D. T., and Przuntek, H. (1995). “Head tremor due to bilateral thalamic and midbrain infarction,” J. Neurol. 242: 608–10.
Pandey, P., Bell-Stephens, T., and Steinberg, G. K. (2010). “Patients with moyamoya disease presenting with movement disorder,” J. Neurosurg. Pediatr. 6: 559–66.
Pantano, P., Di, C. S., Ricci, M., Gualdi, G. F., Sabatini, U., and Di, P. (1996). “Hemichorea after a striatal ischemic lesion: evidence of thalamic disinhibition using single-photon emission computed tomography: a case report,” Mov. Disord. 11: 444–7.
Park, S. Y., Kim, H. J., Cho, Y. J., Cho, J. Y., and Hong, K. S. (2009). “Recurrent hemichorea following a single infarction in the contralateral subthalamic nucleus,” Mov. Disord. 24: 617–18.
Peralta, C., Stampfer-Kountchev, M., Karner, E., Köllensperger, M., Geser, F., Wolf, E., et al. (2007). “Orthostatic hypotension and attention in Parkinson’s disease with and without dementia,” J. Neural. Transm. 114: 585–8.
Peralta, C., Werner, P., Holl, B., Kiechl, S., Willeit, J., Seppi, K., et al. (2004). “Parkinsonism following striatal infarcts: incidence in a prospective stroke unit cohort,” J. Neural. Transm. 111: 1473–83.
Persoon, S., Kappelle, L. J., and Klijn, C. J. (2010a). “Limb-shaking transient ischaemic attacks in patients with internal carotid artery occlusion: a case-control study,” Brain 133: 915–22.
Persoon, S., Kappelle, L. J., and Klijn, C. J. (2010b). “Limb-shaking transient ischaemic attacks in patients with internal carotid artery occlusion: a case-control study,” Brain 133: 915–22.
Pettigrew, L. C. and Jankovic, J. (1985). “Hemidystonia: a report of 22 patients and a review of the literature,” J. Neurol. Neurosurg. Psychiatry 48: 650–7.
Piccolo, I., Defanti, C. A., Soliveri, P., Volonte, M. A., Cislaghi, G., and Girotti, F. (2003). “Cause and course in a series of patients with sporadic chorea,” J. Neurol. 250: 429–35.
Qureshi, F., Morales, A., and Elble, R. J. (1996). “Tremor due to infarction in the ventrolateral thalamus,” Mov. Disord. 11: 440–4.
Reider-Grosswasser, I., Bornstein, N., and Korczyn, A. (1995). “Parkinsonism in patients with lacunar infarcts of the basal ganglia,” Eur. Neurol. 35: 46–9.
Remy, P., de Recondo, A., Defer, G., Loc’h, C., Amarenco, P., Plante-Bordeneuve, V., et al. (1995). “Peduncular ‘rubral’ tremor and dopaminergic denervation: a PET study,” Neurology 45: 472–7.
Schulze-Bonhage, A. and Ferbert, A. (1998). “Cortical action tremor and focal motor seizures after parietal infarction,” Mov. Disord. 13: 356–8.
Schwartz, M., De Deyn, P. P., Van den Kerchove, M., and Pickut, B. A. (1995). “Cervical dystonia as a probable consequence of focal cerebral lesion,” Mov. Disord. 10: 797–8.
Scott, B. L. and Jankovic, J. (1996). “Delayed-onset progressive movement disorders after static brain lesions,” Neurology 46: 68–74.
Sethi, K. D., Nichols, F. T., and Yaghmai, F. (1987). “Generalized chorea due to basal ganglia lacunar infarcts,” Mov. Disord. 2: 61–6.
Sethi, K. D. and Patel, B. P. (1990). “Inconsistent response to divalproex sodium in hemichorea/hemiballism,” Neurology 40: 1630–1.
Smith, E. E., Schneider, J. A., Wardlaw, J. M., and Greenberg, S. M. (2012). “Cerebral microinfarcts: the invisible lesions,” Lancet Neurol. 11: 272–82.
Spielberger, S., Hotter, A., Wolf, E., Eisner, W., Müller, J., Poewe, W., et al. (2012). “Deep brain stimulation in Huntington’s disease: a 4-year follow-up case report,” Mov. Disord. 27: 806–7.
Staekenborg, S. S., van Straaten, E. C., van der Flier, W. M., Lane, R., Barkhof, F., and Scheltens, P. (2008). “Small vessel versus large vessel vascular dementia: risk factors and MRI findings,” J. Neurol. 255: 1644–51.
Tabaton, M., Mancardi, G., and Loeb, C. (1985). “Generalized chorea due to bilateral small, deep cerebral infarcts,” Neurology 35: 588–9.
Tan, E. K., Chan, L. L., and Auchus, A. P. (2001). “Complex movement disorders following bilateral paramedian thalamic and bilateral cerebellar infarcts,” Mov. Disord. 16: 968–70.
Tarsy, D. and Simon, D. K. (2006). “Dystonia,” N. Engl. J. Med. 355: 818–29.
Thompson, P. D. and Marsden, C. D. (1987). “Gait disorder of subcortical arteriosclerotic encephalopathy: Binswanger’s disease,” Mov. Disord. 2: 1–8.
Tisch, S., Silberstein, P., Limousin-Dowsey, P., and Jahanshahi, M. (2004). “The basal ganglia: anatomy, physiology, and pharmacology,” Psychiatr. Clin. North Am. 27: 757–99.
Tolosa, E. S. and Santamaria, J. (1984). “Parkinsonism and basal ganglia infarcts,” Neurology 34: 1516–18.
Usmani, N., Bedi, G. S., Sengun, C., Pandey, A., and Singer, C. (2011). “Late onset of cervical dystonia in a 39-year-old patient following cerebellar hemorrhage,” J. Neurol. 258: 149–51.
van Zagten, Z. M., Lodder, J., and Kessels, F. (1998). “Gait disorder and parkinsonian signs in patients with stroke related to small deep infarcts and white matter lesions,” Mov. Disord. 13: 89–95.
Vidailhet, M., Jedynak, C. P., Pollak, P., and Agid, Y. (1998). “Pathology of symptomatic tremors,” Mov. Disord. 13(Suppl. 3): 49–54.
Walker, M., Kim, H., and Samii, A. (2007). “Holmes-like tremor of the lower extremity following brainstem hemorrhage,” Mov. Disord. 22: 272–4.
Warlow, C., Sudlow, C., Dennis, M., Wardlaw, J., and Sandercock, P. (2003). “Stroke,” Lancet Neurol. 362: 1211–24.
Wijemanne, S. and Jankovic, J. (2009). “Hemidystonia-hemiatrophy syndrome,” Mov. Disord. 24: 583–9.
Winikates, J. and Jankovic, J. (1994). “Vascular progressive supranuclear palsy,” J. Neural Transm. Suppl. 42: 189–201.
Winikates, J. and Jankovic, J. (1999). “Clinical correlates of vascular parkinsonism,” Arch. Neurol. 56: 98–102.
Yamanouchi, H. and Nagura, H. (1997). “Neurological signs and frontal white matter lesions in vascular parkinsonism. A clinicopathologic study,” Stroke 28: 965–9.
Zadro, I., Brinar, V. V., Barun, B., Ozretic, D., and Habek, M. (2008). “Cervical dystonia due to cerebellar stroke,” Mov. Disord. 23: 919–20.
Zijlmans, J., Evans, A., Fontes, F., Katzenschlager, R., Gacinovic, S., Lees, A. J., et al. (2007). “[123I] FP-CIT spect study in vascular parkinsonism and Parkinson’s disease,” Mov. Disord. 22: 1278–85.
Zijlmans, J. C. (2011). “Vascular chorea in adults and children,” Handb. Clin. Neurol. 100: 261–70.
Zijlmans, J. C., Daniel, S. E., Hughes, A. J., Revesz, T., and Lees, A. J. (2004). “Clinicopathological investigation of vascular parkinsonism, including clinical criteria for diagnosis,” Mov. Disord. 19: 630–40.