Mirror movements induced by hemiballism due to putamen infarction: a case report and literature review

Mirror movements (MMs), which are involuntary movements of one limb that synchronously mirror voluntary movements of the contralateral limb, are a relatively uncommon complication of strokes. Here we report what appears to be the first case of putamen infarction manifesting as MMs in one side of the body induced by contralateral hemiballism. MMs and hemiballism were nearly entirely eliminated after one week of clonazepam and haloperidol therapy. During the subsequent one year of standard ischemic stroke prevention measures, no further episodes of involuntary movement occurred. Our case and literature review highlight that acute stroke can manifest as hemiballism and MMs, which should be recognized as soon as possible to ensure timely management.