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Case Reports in Medicine
Volume 2012, Article ID 768580, 4 pages
http://dx.doi.org/10.1155/2012/768580
Case Report

Hemiballismus, Hyperphagia, and Behavioral Changes following Subthalamic Infarct

1Department of Neurology, Medical School, Isfahan University of Medical Sciences, Isfahan 81744-176, Iran
2Medical School, Isfahan University of Medical Sciences, Isfahan 81744-176, Iran
3Medical Students’ Research Center, Isfahan University of Medical Sciences, Isfahan 81744-176, Iran
4Department of Otolaryngology, Medical School, Isfahan University of Medical Sciences, Isfahan 81744-176, Iran
5Department of Psychiatry, Medical School, Isfahan University of Medical Sciences, Isfahan 81744-176, Iran

Received 4 April 2012; Accepted 1 October 2012

Academic Editor: S. Kennedy

Copyright © 2012 Masoud Etemadifar et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The function of subthalamic nucleus (STN) which is a part of the basal ganglia system is not clear, but it is hypothesized that this component might be involved in action selection. Unilateral damage to STN, which can commonly occur due to the small vessel stroke mainly, causes hemiballismus and sometimes hemichorea-hemiballismus. This paper deals with a 60-year-old patient with sudden onset of abnormal movements in his right limbs. He had increased appetite and hyperphagia and also developed mood and behavioral changes (aggressiveness, irritability, anxiety, and sometimes obscene speech). The magnetic resonance imaging revealed infarct area in left subthalamus. In our case, hemiballismus is caused by infarction in left subthalamic area. Occurrence of irritability, anxiety, and some behavioral changes such as aggressiveness and obscene speech can be explained by impairment of STN role in nonmotor behavior and cognitive function as a result of infarct.