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Abstract Details

Transient Movement Disorder Following Artery of Percheron Occlusion
Cerebrovascular Disease and Interventional Neurology
P9 - Poster Session 9 (8:00 AM-9:00 AM)

We present a patient with acute artery of Percheron occlusion and bilateral paramedian thalamic territory ischemic stroke who developed a temporary hyperkinetic movement disorder 10 days post-stroke characterized by stereotyped repetitive flexion/extension movements elicited with passive movement consistent with clonic perseveration. The frequency and amplitude of the movement was variable, although often started at a low amplitude and frequency with crescendo, then plateau pattern which could last minutes to hours. The patient’s repetitive activity-induced behaviors included not only limb movements, but also repetition of words, phrases, and tasks. Prolonged EEG monitoring excluded seizure activity. Cardiac CT angiogram revealed a left atrial appendage thrombus as the likely cardioembolic source. The artery of Percheron (AOP) is a branch of the P1 segment of one posterior cerebral artery that singly supplies bilateral paramedian thalamic territories. AOP occlusion results in ischemic infarct of both medial thalamic nuclei. The patient’s brain MRI showed lesional extension to the level of the midbrain involving the left red nucleus. This is a unique and rare presentation and only one of a few case reports linking clonic perseveration with thalamic injury. 

Judit Perez Ortiz, MD, PhD
Dr. Perez Ortiz has nothing to disclose.
Samantha Banks, MD (Mayo Clinic) Dr. Banks has nothing to disclose.
BEN JOHNSON-TESCH No disclosure on file
Elizabeth A. Coon, MD, FAAN (Mayo Clinic) Dr. Coon has nothing to disclose.
Zafer Keser, MD (Mayo Clinic) Dr. Keser has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier Practice Update.