—Dr Lang's comments are appreciated. It was not our intention, as implied by Dr Lang's letter, to suggest that the epidemiology of hemiballism-hemichorea has recently changed or that our selected patient population reflects the experience of other neurologists or primary care physicians. We agree that, because of our special interest in movement disorders, our population of patients is probably different from that seen by general neurologists. However, most of the previous series with which we compared our results, although smaller than ours, were also reported from centers specializing in movement disorders, therefore their referral populations should be similar to ours. Rather than a change in epidemiology, we suggest that the younger average age in our patients is due to a more diverse cause of hemiballism-hemichorea. For example, acquired immunodeficiency syndrome, which was not seen at the time of previous studies, was responsible for the hyperkinesia in two of
Jankovic J. Hemiballism-Hemichorea-Reply. Arch Neurol. 1990;47(6):619–620. doi:10.1001/archneur.1990.00530060023007
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