A Case of Post-stroke Rhythmic Akathisia

뇌졸중후 율동성 정좌불능증 1예

Dyskinesia can occur as a neurological abnormality due to stroke, and its incidence in stroke patients is reported to be about 1%. It is possible to classify dyskinesia into one of the morphologic types already classified clinically. However, a specific type of dyskinesia can occur; one which does not fall into the existing morphologic types. We experienced such a case of specific type dyskinesia, which couldn't be classified into the existing classification system. A 50-year-old man visited our hospital due to rhythmic dyskinesia of the right hand, which appeared during the resting state, and had developed one month after left subcortical infarction. Flexion and extension movements of the fingers at 3Hz appeared due to the impatient impulse to move. However, this abnormal movement could be easily suppressed under the patients will. We suggested that the abnormal movement was similar to akathisia from the fact that it occurred due to the internal desire to move and that the patient could suppress dyskinesia. However, the rhythmic tendency and lack of medication history of antipsychotics suggested that the movement was not the typical form of akathisia. The present case may represent a new clinical type of movement disorder developed after stroke. Considering the clinical pattern of the present case and following a review of the literature, we believe that it can be labeled, post-stroke rhythmic akathisia.