The book on Hemiballismus delves into a rare and complex movement
disorder characterized by uncontrollable, violent movements of the limbs
on one side of the body. It begins with an exploration of the disorder's
etiology, pinpointing damage to the subthalamic nucleus due to stroke or
vascular lesions as a primary cause. The pathophysiology section
elucidates how such damage disrupts the indirect pathway in the basal
ganglia, leading to diminished inhibition of thalamocortical projections and
consequent hyperactivity in cortical motor areas.
Diagnosis is discussed through clinical presentation and neuroimaging
findings, setting the stage for an in-depth discussion on treatment
modalities. Traditional pharmacological therapies including antipsychotics,
anticonvulsants, and dopamine-depleting agents are covered extensively.
For refractory cases, surgical interventions like deep brain stimulation or
lesioning procedures are considered.
A significant portion of the book is dedicated to exploring a novel
therapeutic strategy known as the implication approach. This involves non-
invasive neuromodulation techniques such as transcranial magnetic
stimulation (TMS) and transcranial direct current stimulation (tDCS) aimed
at specific neural circuits implicated in hemiballismus' pathogenesis.
Preliminary studies showing promising results with these techniques are
highlighted, particularly their potential in reducing abnormal movements
and improving motor function.
In conclusion, this book presents a comprehensive overview of
hemiballismus from its causes and diagnosis to traditional and innovative
treatments. The exploration of neuromodulation techniques as a viable
treatment option offers hope for patients unresponsive to conventional
therapies. Further research directions are suggested to optimize these
novel approaches, making it an invaluable resource for clinicians,
researchers, and students interested in movement disorders.
