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June 1990


Author Affiliations

Director, Movement Disorders Clinic Toronto Western Hospital, Suite 101 25 Leonard Ave Toronto, Ontario, Canada M5T 2R2

Arch Neurol. 1990;47(6):619. doi:10.1001/archneur.1990.00530060023006

To the Editor.  —I read the article on hemiballism-hemichorea by Dewey and Jankovic1 with interest. One of the points emphasized by the authors was the young age of onset in their patients with respect to the earlier literature. They indicate that this was almost certainly a factor in the diverse causes presented in their report; those cases other than cerebrovascular disease occurred in younger patients, while stroke (still the most common cause) occurred in the patients over age 55. However, without some statement concerning referral patterns, the uninformed reader is left to conclude that the epidemiology of this disorder has changed significantly since the time of the earlier large series quoted in this article. Although hemiballism is an uncommon movement disorder, most neurologists can readily make the correct diagnosis. (1) It is recognized that stroke is the most frequent cause. (2) It is common knowledge (thanks to the literature