Deutetrabenazine in Post-Thalamic Infarction Hemichorea: A Case Report and Literature Review

Background Chorea, a hyperkinetic movement disorder, manifests as involuntary, irregular, rapid, and large-amplitude dance-like movements, such as limb flailing, twisting, and facial grimacing. It can be a primary symptom of neurological disorders directly affecting the basal ganglia, such as Huntington's disease, or a secondary manifestation of various systemic diseases, including infections, autoimmune diseases, drug-induced disorders, metabolic diseases, neurodegenerative diseases, and stroke. Among these, acute cerebrovascular disease is a common cause of chorea. While some patients experience rapid relief of choreiform movements with appropriate symptomatic treatment, others may suffer from refractory chorea that remains difficult to cure despite prolonged pharmacological intervention. Case presentation We present a rare case of refractory post-thalamic infarction hemichorea. After the failure of conventional anti-dopaminergic therapy during the acute phase of cerebral infarction, the patient's symptoms were rapidly controlled with deutetrabenazine without significant adverse effects. Conclusions This report aims to enhance the understanding of treatment strategies for refractory post-stroke chorea and emphasize the potential efficacy of deutetrabenazine in such cases, providing an alternative therapeutic approach for refractory post-stroke hemichorea.