Hemiballismus: A Case Series in Uyo Southern Nigeria and a Review of Available Literature

Hemiballismus is a dramatic movement disorder that is typically acute in onset. It usually involves one side of the body affecting the proximal limb more than the distal. The commonest recognized etiology remains cerebrovascular diseases. Very few cases have been reported in Africa. We describe six cases seen in our hospital with their presentation, management and eventual outcome. The participants were six patients admitted and treated in our practice from January 2010-December 2012. The folders of those who had been discharged were reviewed and reported as follows. Six patients presented with sudden uncontrollable flinging movements. There were two males and four females. The age range was 55-68 years. All the patients were from the Ibibio ethnic group in the Southern Nigeria. The patients presented within the first week of the abnormal movements. They all had modifiable and non-modifiable risk factors for stroke. All the patients had supportive management and had remarkable improvement. Hemiballismus may not be as rare as previously thought. This sudden surge may be part of the transition from communicable to non-communicable diseases noted in sub Saharan Africa. There may also be an associated environmental factor and/or genetic predilection given that all the patients come from the same ethnic group and reside in the same environment. Patients do well on supportive care.