Ballism

Ballism is a rare movement disorder characterized by involuntary, violent, flinging movements of the limbs. It is often considered a severe form of chorea, which involves irregular, unpredictable movements. Ballism typically affects one side of the body, a condition known as hemiballismus, but it can also occur on both sides, known as biballismus.

Causes

Ballism is most commonly caused by a lesion in the subthalamic nucleus of the basal ganglia. This lesion can result from various conditions, including stroke, traumatic brain injury, infection, or tumor. Less commonly, ballism can be associated with metabolic disorders such as hyperglycemia.

Symptoms

The primary symptom of ballism is the sudden onset of large-amplitude, flinging movements of the limbs. These movements are typically more severe in the proximal parts of the limbs, such as the shoulders and hips, and can interfere significantly with daily activities. The movements are usually continuous and can be exacerbated by voluntary movements or stress.

Diagnosis

Diagnosis of ballism is primarily clinical, based on the characteristic movements. Neuroimaging techniques such as MRI or CT scan can help identify the underlying cause, such as a lesion in the subthalamic nucleus. Electromyography (EMG) may also be used to study the muscle activity associated with the movements.

Treatment

Treatment of ballism focuses on addressing the underlying cause and managing symptoms. Medications such as antipsychotics, anticonvulsants, and dopamine-depleting agents can help reduce the severity of the movements. In some cases, surgical intervention such as deep brain stimulation (DBS) may be considered.

Prognosis

The prognosis for individuals with ballism varies depending on the underlying cause. In cases related to stroke or trauma, the condition may improve over time with appropriate treatment. However, if the underlying cause is a progressive disease, the prognosis may be less favorable.

Related Pages

• Chorea
• Hemiballismus
• Basal ganglia
• Subthalamic nucleus
• Deep brain stimulation
• Hyperglycemia