Dystonic posturing with athetoid movements in stroke without thalamic lesion.

Complex hyperkinetic movement disorders are a rare complication of stroke, frequently involving posterolateral contralateral thalamic lesions. One of the proposed mechanisms for these presentations is proprioceptive impairment, hence not involving deregulation of the basal ganglia-thalamocortical circuits. We report a patient who presented with dystonic posturing and athetoid movements with onset 2 years after right frontoparietotemporal stroke. Brain MRI showed no thalamic lesion. Based on the phenomenology, a diagnosis of pseudochoreoathetosis was proposed. To our knowledge, this is the first case report of poststroke pseudochoreoathetosis without thalamic involvement.

Structural disconnectome analysis of acute freezing of gait due to parietal stroke: implications for FOG pathogenesis.

Acute onset isolated freezing of gait (FOG) is a rare and defying diagnosis. Its pathophysiology is not yet totally understood and several brain regions seem to be involved. Postlesional FOG can help to shed light on the networks involved.We report a case of an 80-year-old woman who presented to the emergency department with acute onset impairment of gait. Her medical history was unremarkable. On neurological examination she was presented with difficulties in gait initiation, turning and progressing through narrow spaces. Her remaining neurological examination was unremarkable. Brain CT showed a subacute cortico-subcortical right parieto-occipital infarction. Acute isolated FOG due to parieto-occipital stroke was diagnosed. A structural disconnectome analysis showed that the lesion disrupted structural connections with the ipsilateral ventral striatum. This case highlights that acute onset FOG might be a consequence of a parietal cortical lesion.