Lesion-induced hemichorea-ballism: A systematic review of 586 cases.
Elina Myller, Vilja Minkkinen, Elizabeth G Ellis et al.
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In 30 seconds
This systematic review examined clinical features and lesion locations in 586 published cases of lesion-induced hemichorea-ballism identified through January 2025. Only 24.6 % had lesions intersecting the subthalamic nucleus (STN), while 83.1 % developed symptoms within 7 days. Symptomatic pharmacotherapy was associated with a response in 82.2 % of cases, and 52.8 % remitted. Lesion location was associated with clinical presentation and prognosis: STN lesions differed from non-STN lesions in several clinical outcomes, while pure cortical lesions had a more favorable prognosis than non-STN lesions involving subcortical structures.
Key findings
- Only 24.6 % of the 586 cases had lesions intersecting the STN.
- Acute symptom-onset within 7 days occurred in 83.1 % of cases.
- Symptomatic pharmacotherapy response was reported in 82.2 % of cases; 52.8 % remitted.
- Compared with other non-STN lesions, pure cortical lesions were associated with a more favorable prognosis and shorter delay to remission (P < 0.001).
Why it matters
The findings challenge the assumption that hemichorea-ballism is usually linked to STN lesions and show that lesion location corresponds to differences in presentation and prognosis. Recognising this heterogeneity may help clinicians interpret lesion-related movement disorders and frame expectations about clinical course, while the review’s descriptive evidence does not establish causation.
What to keep in mind
The review synthesises published case reports, so findings are descriptive and may reflect reporting and selection biases; the abstract does not report comparative effect sizes.