Hemichorea is an uncommon hyperkinetic movement disorder characterized by abrupt, irregular, non-rhythmic movements affecting one side of the body. Although most stroke presentations involve motor, sensory and speech deficits, hyperkinetic movement disorders can occasionally be the initial or sole manifestation of stroke. The commonest hyperkinetic movement disorders are hemichorea, hemiballismus or dystonia syndrome. ^[1] Historically linked to lesions of the subthalamic nucleus or basal ganglia, more recent case reports and studies have shown a broader network of lesion sites; including cortical and even ipsilateral strokes, may be involved ^[2].

In this report, we present a patient who presented with hemichorea at onset of stroke, and we also analysed the literature review of hyperkinetic movement disorder as the presenting symptom of stroke, network localization and clinical radiological correlation

Our patient presented with acute onset of involuntary jerky movements involving the left side of the body and his imaging showed right parietal infarct. He was treated conservatively and improved over the course.