nnpNeurology, Neuropsychiatry, PsychosomaticsНеврология, нейропсихиатрия, психосоматика2074-27112310-1342"IMA-Press", LLC10.14412/2074-2711-2025-6-4-12nnp-2731Research ArticleLECTURESЛЕКЦИЯHyperkinetic movement disorders in the onset of strokeГиперкинетические синдромы в дебюте острых нарушений мозгового кровообращенияhttps://orcid.org/0000-0001-5805-486XКатунинаЕ. А.KatuninaE. A.

117513, Москва, ул. Островитянова, 1, стр. 6; 117513, Москва, ул. Островитянова, 1, стр. 10

Elena Anatolyevna Katunina

1, Ostrovityanova St., Build. 6, Moscow 117513; 1, Ostrovityanova St., Build. 10, Moscow 117513

elkatunina@mail.ruhttps://orcid.org/0000-0003-2797-7877МартыновМ. Ю.MartynovM. Yu.

117513, Москва, ул. Островитянова, 1, стр. 6; 117513, Москва, ул. Островитянова, 1, стр. 10; 119049, Москва, Ленинский проспект, 8

1, Ostrovityanova St., Build. 6, Moscow 117513; 1, Ostrovityanova St., Build. 10, Moscow 117513; 8, Leninsky Prosp., Moscow 119049

https://orcid.org/0000-0003-3930-5998ДолгушинМ. Б.DolgushinM. B.

117513, Москва, ул. Островитянова, 1, стр. 10

1, Ostrovityanova St., Build. 10, Moscow 117513

https://orcid.org/0009-0004-7073-5472БогомазоваВ. А.BogomazovaV. A.

117513, Москва, ул. Островитянова, 1, стр. 6; 117513, Москва, ул. Островитянова, 1, стр. 10

1, Ostrovityanova St., Build. 6, Moscow 117513; 1, Ostrovityanova St., Build. 10, Moscow 117513

https://orcid.org/0009-0003-4472-6604ГлотоваН. А.GlotovaN. A.

117513, Москва, ул. Островитянова, 1, стр. 10

1, Ostrovityanova St., Build. 10, Moscow 117513

https://orcid.org/0000-0003-2360-3261ГуминИ. С.GuminI. S.

117513, Москва, ул. Островитянова, 1, стр. 10

1, Ostrovityanova St., Build. 10, Moscow 117513

ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России; ФГБУ «Федеральный центр мозга и нейротехнологий» ФМБА РоссииРоссияN.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia; Federal Center for Brain and Neurotechnologies, Federal Medical Biological Agency of RussiaRussian FederationФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России; ФГБУ «Федеральный центр мозга и нейротехнологий» ФМБА России; ГБУЗ «Городская клиническая больница № 1 им. Н.И. Пирогова» Департамента здравоохранения г. МосквыРоссияN.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia; Federal Center for Brain and Neurotechnologies, Federal Medical Biological Agency of Russia; N.I. Pirogov City Clinical Hospital No.1, Healthcare Department of MoscowRussian FederationФГБУ «Федеральный центр мозга и нейротехнологий» ФМБА РоссииРоссияFederal Center for Brain and Neurotechnologies, Federal Medical Biological Agency of RussiaRussian Federation202520122025176412Copyright © Katunina E.A., Martynov M.Y., Dolgushin M.B., Bogomazova V.A., Glotova N.A., Gumin I.S., 20252025Катунина Е.А., Мартынов М.Ю., Долгушин М.Б., Богомазова В.А., Глотова Н.А., Гумин И.С.Katunina E.A., Martynov M.Y., Dolgushin M.B., Bogomazova V.A., Glotova N.A., Gumin I.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://nnp.ima-press.net/nnp/article/view/2731

Hyperkinetic movements (HM) as the sole or leading syndrome in the onset of stroke is observed in less than 1% of stroke cases and can lead to diagnostic difficulties, disrupting routing and delaying the administration of reperfusion therapy.

Four observations are presented: two with acute development of hemichorea/hemiballismus and one each with recurrent transient episodes of myoclonus and spastic torticollis. According to neuroimaging data, in patients with hemichorea/hemiballismus, the foci were located in the anterior parts of the corona radiata in the projection of the descending pathways from the cortex to the striatum and in the putamen. In a patient with spastic torticollis, the focus was in the thalamus. In a patient with recurrent myoclonic hyperkinesis, no changes in perfusion (CBV and Tmax) were found during hyperkinesis, but computed tomography revealed post-stroke cysts in the right somatosensory area and in the right hemisphere of the cerebellum.

The occurrence of HM may be caused not only by structural changes, but also by functional disorders of the neural networks involved in the integration of motor activity.

Гиперкинезы как единственный или ведущий синдром в дебюте острых нарушений мозгового кровообращения (ОНМК) наблюдаются менее чем в 1% случаев ОНМК и могут приводить к диагностическим сложностям, нарушая маршрутизацию и откладывая проведение реперфузионной терапии.

Приведены четыре наблюдения: два – с острым развитием гемихореи/гемибаллизма и по одному – с повторными преходящими эпизодами миоклонии и со спастической кривошеей. По данным нейровизуализации, у пациентов с гемихореей/гемибаллизмом очаги локализовались в передних отделах лучистого венца в проекции нисходящих путей от коры к полосатому телу и в скорлупе. У пациента со спастической кривошеей очаг был в зрительном бугре. У пациента с повторяющимся миоклоническим гиперкинезом изменений перфузии (CBV и Tmax) во время гиперкинеза не установлено, но при компьютерной томографии выявлены постинсультные кисты в правой соматосенсорной области и в правом полушарии мозжечка.

Возникновение гиперкинезов может быть обусловлено не только структурными изменениями, но и функциональным нарушением нейронных сетей, участвующих в интеграции двигательного акта.

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The authors declare that there are no conflicts of interest present.