Acute Hemichorea in a Young Patient Secondary to Ischemic Infarction in the Right Lentiform Nucleus: A Case Report

Abstract

Chorea is a hyperkinetic movement disorder characterised by brief, unpredictable, dance-like involuntary movements involving multiple body parts. Hemichorea is its unilateral variant, affecting one side of the body. Both can arise from diverse aetiologies, including genetic, vascular, metabolic, autoimmune, drug-induced, and infectious causes. We report the case of a 31-year-old male with no significant past medical history who developed sudden-onset, left-sided hemichorea and homonymous hemianopia. Brain MRI demonstrated an acute right lentiform infarct, predominantly involving the globus pallidus. The patient improved markedly within 24 hours following the initiation of antiplatelet therapy. Further investigations revealed a Stage 2A-shunt patent foramen ovale, deemed the likely aetiology. This case underscores the importance of recognising hemichorea as a rare but possible manifestation of acute ischaemic stroke and highlights the need for comprehensive diagnostic evaluation in young patients presenting with atypical stroke symptoms.