Bilateral ballism in multiple sclerosis

Ballism, also called ballismus, is a neurological symptom of swinging, jerking, or flinging. It is usually observed only on one side; bilateral ballism is quite rare. The authors report the case of a 35-year-old man who had been previously diagnosed with multiple sclerosis. The patient made continuous flinging movements, which were more pronounced when the patient was intending to move. The movements disappeared during sleep. The patient died almost six years later and the brain became available for pathologic examination. Lesions were seen in several areas, including the thalamus, hypothalamus, and subthalamic nuclei. In addition, lesions were observed in both sides of the basal ganglia, which consist of the caudate, putamen, and globus pallidus. The observations support the prevailing belief that ballism results from lesions in the basal ganglia and the subthalamic nuclei. (Consumer Summary produced by Reliance Medical Information, Inc.)