Abnormal Hyperkinetic Movements Post Acute Stroke

Clinical Features of Hyperkinetic Involuntary Movements Controlateral to Hemiplegia in Acute Stroke

The occurrence of abnormal movements is a frequent reason for consultation in neurology. The etiologies are broadly separated into "primary causes", intrinsically neurological diseases (of genetic or degenerative origin), and "secondary causes". In addition to certain medications or toxic substances, brain damage can be a cause. In this register, 22% of involuntary abnormal movements are related to a stroke and 1 to 4% of strokes are complicated by abnormal movements.

These are manifested by a parkinsonian syndrome or conversely by hypercinesia which can take the form of chorea or ballisms. Most hyperkinetic movements occur in the acute phase of the neurovascular event.

The frequency of these abnormal movements is still uncertain and their semeiological description has been the subject of only rare publications. It seems relevant to be interested in the frequency of these neurological phenomena and has their semeiologic characteristic

Study Overview

• Status: Recruiting
• Conditions: Neurology Department

Detailed Description

The occurrence of abnormal movements is a frequent reason for consultation in neurology. The etiologies are broadly separated into "primary causes", in example intrinsically neurological diseases (of genetic or degenerative origin), and "secondary causes". In addition to certain medications or toxic substances, brain damage can be a cause. In this register, 22% of involuntary abnormal movements are related to a stroke and 1 to 4% of strokes are complicated by abnormal movements.

These are manifested by a parkinsonian syndrome or conversely by hypercinesia which can take the form of chorea or ballisms. Most hyperkinetic movements occur in the acute phase of the neurovascular event. . The pathophysiology seems simple and explained by a direct lesion or hypoperfusion of structures involved in the loops of the basal ganglia, especially when the putamen is affected. Intuitively, these abnormal hyperkinetic movements affect the contralateral hemibody to the vascular lesion, or the ipsilateral rating to the sensory and/ or motor deficit. However, observations have already been reported of involuntary hyperkinetic abnormal movements of the contralateral side to that presenting hemiplegia, i.e. in theorie controlled by a cerebral hemisphere free of acute cerebral lesion.

The frequency of these abnormal movements is still uncertain and their semeiological description has been the subject of only rare publications. A largest cohort reports abnormal involuntary movements very heterogeneous as to their clinical presentation (rotation of the head, orpharyngeal stereotypies to the limbs, compulsive manipulations of the environment or repeated passive mobilization of the contralateral limb paralyzed) In addition, the correlation of this type of neurological manifestations with vascular lesions has not yet been elucidated.

However, the unusual nature of this type of movement, it seems relevant to be interested in the frequency of these neurological phenomena and has their semeiologic characteristic.

• Study Type: Observational
• Enrollment (Anticipated): 15

Contacts and Locations

• Study Contact: Name: Thomas DE BROUCKER, MD; Phone Number: 01 42 35 62 97; Email: thomas.debroucker@ch-stdenis.fr
• Study Contact Backup: Name: Guillaume BAILLE, MD, PhD; Phone Number: 01 42 35 62 97; Email: guillaume.baille@ch-stdenis.fr

Study Locations

• France
  • ILE DE France
    • Saint Denis, ILE DE France, France, 93200
      • Recruiting
      • Hopital DELAFONTAINE
      • Contact: Stéphanie Cossec; Phone Number: 6962 0142356140; Email: coordination.rechercheclinique@ghtpdfr.fr
      • Principal Investigator: Guillaume BAILLE, MD PH

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

patients with abnormal hyperkinetic movements post-stroke, managed in the neurovascular intensive care unit

Description

Inclusion Criteria:

• Adult patients (age 18 years old)
• Patients with a stroke treated in the neurovascular intensive care unit of the Delafontaine Hospital in Saint-Denis (Hospitalization within 48 hours of the onset of the neurovascular episode
• Patients with abnormal hyperkinetic movements

Exclusion Criteria:

• Opposition of the patient or his entourage to participation in the registry
• Abnormal myoclonic movements of an epileptic nature
• Minor patients

Study Plan

How is the study designed?

Design Details

• Observational Models: Case-Only
• Time Perspectives: Prospective

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
incidence of abnormal contralateral movements to hemiplegia in the acute phase of a stroke	incidence of abnormal contralateral movements to hemiplegia in the acute phase of a stroke	Day 1

Collaborators and Investigators

• Sponsor: Centre Hospitalier de Saint-Denis

Publications and helpful links

General Publications

• Mehanna R, Jankovic J. Movement disorders in cerebrovascular disease. Lancet Neurol. 2013 Jun;12(6):597-608. doi: 10.1016/S1474-4422(13)70057-7. Epub 2013 Apr 19. Erratum In: Lancet Neurol. 2013 Aug;12(8):733.
• Defebvre L, Krystkowiak P. Movement disorders and stroke. Rev Neurol (Paris). 2016 Aug-Sep;172(8-9):483-487. doi: 10.1016/j.neurol.2016.07.006. Epub 2016 Jul 28.
• Vercueil L, Andriantseheno ML, Umeda Y, Carre S, Sellal F. Hyperkinesia contralateral to acute hemiplegia: relevance of previous frontal lesions. Parkinsonism Relat Disord. 2000 Apr 1;6(2):107-110. doi: 10.1016/s1353-8020(99)00059-0.
• Ghika J, Bogousslavsky J, van Melle G, Regli F. Hyperkinetic motor behaviors contralateral to hemiplegia in acute stroke. Eur Neurol. 1995;35(1):27-32. doi: 10.1159/000117085.

Study record dates

Study Major Dates

• Study Start (Actual): May 23, 2022
• Primary Completion (Anticipated): September 30, 2022
• Study Completion (Anticipated): December 31, 2022

Study Registration Dates

• First Submitted: May 19, 2022
• First Submitted That Met QC Criteria: May 19, 2022
• First Posted (Actual): May 24, 2022

Study Record Updates

• Last Update Posted (Actual): May 25, 2022
• Last Update Submitted That Met QC Criteria: May 24, 2022
• Last Verified: May 1, 2022

More Information

Terms related to this study

• Keywords: hyperkinetic movements; acute stroke
• Additional Relevant MeSH Terms: Cardiovascular Diseases; Vascular Diseases; Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Stroke
• Other Study ID Numbers: CHSD_0018_NEURO; 2021-A03230-41 (Registry Identifier: IDRCB)

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No