ballismus

Ballism: description

The word ballism comes from the Greek and means “throw” or “hurl”.

The ballism manifests itself as a far-extending, fast and hurling motion sequence that occurs impulsively. The spin is also called Jaktation. This movement disorder is particularly emphasized on the fuselage sections of the arms and legs, ie the upper arms and thighs. During the most frequently occurring ballistic attacks there is a high risk of injury for the person concerned, since the movements are not controllable.

Ballism is one of the so-called hyperkinetic movement disorders. Hyperkinetic means: with “excessive energy”.

Often, the ballism occurs unilaterally. In this case we speak of hemiballism. Similar overshooting movements occur in the chorea or athetosis. In part, ballism is also understood as a form of chorea. This refers to fast and uncontrollable movements of the face and the trunk-distant sections of the arms and legs.

Ballism: causes and possible diseases

The cause of the ballism is damage in the area of ​​movement control of the brain (including the globus pallidus, putamen or caudate nucleus). Often it concerns a special brain region, the so-called subthalamic nucleus. This nucleus (= nucleus) of gray matter belongs to the so-called Zwischenhirn. It is located at a central position in the brain below an important switch point for incoming and outgoing nerve signals, the thalamus.

The subthalamic nucleus is involved in an important regulatory system of motion control and regulation and has an inhibitory function. Since the brain consists of two halves, it gives it twice. If it only fails on one side, the movement disorder occurs only on one side (hemiballism). An overactivity of the subthalamic nucleus, however, leads to hypokinetic movement disorders, which means that those affected are particularly poor in movement.

In most cases, a (temporary) blood supply of this subthalamic nucleus by a hemorrhage or a vascular occlusion is responsible for the symptoms of the ballistics. But infections (such as syphilis or tuberculosis) as well as tumors and metastases can damage the subthalamic nucleus. In rare cases, brain injuries are responsible for the ballism. While sleep leads to an alleviation of the symptoms, the ballism increases with mental arousal.

Ballism: When should you go to the doctor?

Ballism is always a serious symptom that needs to be clarified by a neurologist.

Ballism: What does the doctor do?

The specialist in diagnosis and therapy of ballism or hemiballism is the neurologist, a specialist in diseases of the nervous system. Mostly, the diagnosis can already be made by the typical description or an observed attack. However, it is not easy to distinguish the three similar movement disorders, chorea, athetosis and ballism.

For the distinction, a detailed description of the attacks is important. First of all, the doctor will ask questions such as:

• How long does the movement disorder last?
• How often do ballistic episodes occur?
• Are there factors that trigger a ballism?
• Does the movement disorder arise from rest or movement?

Thereafter, the doctor will examine the patient in detail neurologically. In addition he checks the function of the twelve cranial nerves, individual brain areas and the sensitivity as well as motor skills.

In addition, it may be necessary to examine blood and brain water. In order to gain brain water, a so-called CSF or lumbar puncture must be performed. To do this, a needle is inserted between the lower lumbar vertebrae to draw some brain water out of the space around the spinal cord.

Even so-called imaging studies such as computed tomography (CT) or magnetic resonance imaging (MRI) can be helpful in the correct diagnosis. Calcifications or infarcts may show up in the area of ​​the subthalamic nucleus.

In certain cases, a recording of the brain waves (electroencephalogram) is performed.

Ballism: treatment

In order to interrupt a ballistic attack, the antiepileptic (anticonvulsant) valproate or so-called neuroleptics is usually used. Less frequently, the so-called benzodiazepines are used. During a ballistic attack, the victim must be protected from injury by the ausschlagenden movements.

In severe cases, neurosurgical intervention in the form of electrical stimulation or removal of certain areas of the brain (stereotactic brain surgery) may be considered as a long-term treatment.

Ballism: You can do that yourself

ballismus may be an indication of a serious neurological disorder. Find a doctor!