Post-stroke movement disorders can develop during or after a stroke. They include conditions like hemiballismus and tardive dyskinesia. The pathophysiology involves disruptions to motor control circuits in the brain from the stroke. Most cases spontaneously resolve within 6-12 months, but some patients require pharmacological treatment or even surgery for severe, persistent cases. Prognosis depends on factors like age of onset, duration of symptoms, and whether the movement disorder is generalized or localized.

1. Post-Stroke
Movement Disorders
Ade Wijaya, MD – September 2018

2. Introduction
Ghika-Schmid F, Ghika J, Regli F, Bogousslavsky J. Hyperkinetic movement disorders during and after acute stroke: the Lausanne stroke registry. J Neurol Sci. 1997;146(2):109–116.

3. Fahn S, Jankovic J, Hallett M. Clinical overview and phenomenology of movement disorders. In: Fahn S, Jankovic J, Hallett M, editors. Principles and Practice of Movement Disorders. 2nd ed. Edinburgh, United Kingdom: Elsevier Saunders; 2011. pp. 1–35.
Tardive Dyskinesia: A Task Force Report of the American Psychiatric Association. Washington, DC: American Psychiatric Association Press; 1992. Differential diagnosis of tardive dyskinesia.
Albanese A, Jankovic J. Distinguishing clinical features of hyperkinetic disorders. In: Albanese A, Jankovic J, editors. Hyperkinetic Movement Disorders: Differential Diagnosis and Treatment. Oxford, United Kingdom: Wiley-Blackwell; 2012. pp. 3–14.
Dewey RB, Jr, Jankovic J. Hemiballism-hemichorea. Clinical and pharmacologic findings in 21 patients.Arch Neurol. 1989;46(8):862–867.
Vidakovic A, Dragasevic N, Kostic VS. Hemiballism: report of 25 cases. J Neurol Neurosurg Psychiatry.1994;57(8):945–949

4. Pathophysiology
Mehanna R, Jankovic J. Movement disorders in cerebrovascular disease. The Lancet Neurology. 2013 Jun 1;12(6):597-608

5. Treatment
Siniscalchi A, Gallelli L, Labate A, Malferrari
G, Palleria C, De Sarro G. Post-stroke
movement disorders: clinical manifestations
and pharmacological management. Current
neuropharmacology. 2012 Sep 1;10(3):254-62.

6. Prognosis
 Immediate vs delayed progressive
 Outcome varies
 Younger age, younger duration, generalized disorders
Mehanna R, Jankovic J. Movement disorders in cerebrovascular disease. The Lancet Neurology. 2013 Jun 1;12(6):597-608

8. Summary
 Dyskinesia in adults are mostly caused by stroke
 Most cases spontaneously resolve in 6-12 months
 Pharmacological treatment. Surgery for severe and persistent cases