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Bilateral cerebellar ataxia as the sole manifestation of a unilateral rostral pontine tegmental infarct
  1. H Lee,
  2. Y-W Cho
  1. Department of Neurology, and Brain Research Institute, Keimyung University School of Medicine, Daegu, South Korea
  1. Correspondence to:
 Dr H Lee
 Department of Neurology, Keimyung University School of Medicine, 194 Dongsan dong, Daegu 700-712, South Korea; hleedsmc.or.kr

https://doi.org/10.1136/jnnp.74.10.1445

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    It has been reported that a small infarct of the pons can lead to various clinical syndromes such as pure motor hemiparesis, sensorimotor stroke, ataxic hemiparesis, dysarthria-clumsy hand syndrome, or ataxic tetraparesis.1 However, bilateral, cerebellar ataxia as the sole manifestation of rostral pontine tegmental infarction has not been described. We report a patient with isolated bilateral cerebellar ataxia as the only sign of a rostral pontine tegmental infarct. This unique presentation reflected the selective involvement of part of the decussation of the superior cerebellar peduncle.

    Case report

    A 51 year old man with hypertension developed acute severe imbalance. On examination, he tended to fall to the right when standing unsupported with eyes open. He did not have dysarthria, limb weakness, vertigo, nystagmus, ophthalmoparesis, diplopia, sensory loss, or Horner’s syndrome. The muscle stretch reflexes were …

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