Clinical trial NCT05388552: Abnormal Hyperkinetic Movements Post Acute Stroke
Official title: Clinical Features of Hyperkinetic Involuntary Movements Controlateral to Hemiplegia in Acute Stroke
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: Neurology Department
Keywords: hyperkinetic movements
acute stroke
Lead sponsor: Centre Hospitalier de Saint-Denis
Sponsor class: OTHER
First posted: 2022-05-24
Enrollment: 15
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: CASE_ONLY
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: patients with abnormal hyperkinetic movements post-stroke, managed in the neurovascular intensive care unit

Brief summary: 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

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.

Eligibility criteria: 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

Primary outcomes:
measure: incidence of abnormal contralateral movements to hemiplegia in the acute phase of a stroke
timeFrame: Day 1
Secondary outcomes:
Other outcomes:
Locations:
city: Saint Denis
country: France
facility: Hôpital DELAFONTAINE
state: ILE DE France
Study officials:
References:
citation: 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.
citation: 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.
citation: 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.
citation: 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.