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August 1984, Vol 41, No. 8 >
Article | August 1984

Painful Ataxic Hemiparesis

Julien Bogousslavsky, MD; Franco Regli, MD; Joseph Ghika, MD; Jean-Jacques Feldmeyer, MD
[+] Author Affiliations

Accepted for publication Aug 13, 1983.

Reprint requests to Department of Neurology, Centre Hospitalier Universitaire Vaudois, 1011 Lausanne, Switzerland (Dr Bogousslavsky).


Arch Neurol. 1984;41(8):892-893. doi:10.1001/archneur.1984.04050190102024
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References
Comments

• Right hemiparesis with right-sided pain and ataxia developed in a 68-year-old man. Sensation, neuropsychological function, and somatosensory evoked potentials were normal. Computed tomography showed an isolated fresh infarct in the left part of the thalamus. The pain and ataxic disturbances were related to involvement of the thalamus itself, but the hemiparesis with hyperactive tendon reflexes and Babinski's sign was probably due to associated dysfunction in the adjacent internal capsule from compression or edema. In the available clinicopathological reports of cases with hemiparesis and thalamic infarction, contiguous involvement of the internal capsule or no associated lesion has been reported. Because of the occurrence of pain, which is not present in pontine, mesencephalic, or capsular ataxic hemiparesis, we suggest that the syndrome seen in our patient be called "painful ataxic hemiparesis."

REFERENCES

1 +
Fisher CM:  Ataxic hemiparesis . Arch Neurol 1978;;35:126-128.
2 +
Fisher CM, Cole M:  Homolateral ataxia and crural paresis: A vascular syndrome . J Neurol Neurosurg Psychiatry 1965;;28:48-55.
3 +
Perman GP, Racy A:  Homolateral ataxia and crural paresis: Case report . Neurology 1980;; 30:1013-1015.
4 +
Sakai T, Murakami S, Ito K:  Ataxic hemiparesis with trigeminal weakness . Neurology 1981;;31:635-636.
5 +
Ichikawa K, Tsutsumushita A, Fujioka A:  Capsular ataxic hemiparesis . Arch Neurol 1982;; 39:585-586.
6 +
Iragui VJ, McCutchen CB:  Capsular ataxic hemiparesis . Arch Neurol 1982;;39:528-529.
7 +
Jokelainen M, Pilke A:  Ataxic hemiparesis . Arch Neurol 1983;;40:326.
8 +
Tredici G, Bogliun G, Sanguineti I:  Capsular ataxic hemiparesis . Arch Neurol 1983;;40:326.
9 +
De Renzi E, Nichelli P, Crisi G:  Hemiataxia and crural hemiparesis following capsular infarct . J Neurol Neurosurg Psychiatry 1983;; 46:561-563.
10 +
Pullicino P, Nelson RF, Kendall BE, et al:  Small deep infarcts diagnosed on computed tomography . Neurology 1980;;30:1090-1096.
11 +
Weisberg LA:  Lacunar infarcts: Clinical and computed tomographic correlations . Arch Neurol 1982;;39:37-40.
12 +
Donnan GA, Tress BM, Bladin PF:  A prospective study of lacunar infarction using computerized tomography . Neurology 1982;;32:49-56.
13 +
Radhakrishnan K, Malhotra AK, Shridharan R, et al:  Ataxic hemiparesis: Clinical, electrophysiologic, radiologic and pathologic observations . Clin Neurol Neurosurg 1982;;84:91-100.
14 +
Schnapper RA:  Pontine hemorrhage presenting as ataxic hemiparesis . Stroke 1982;; 13:518-519.
15 +
Bendheim PE, Berg BO:  Ataxic hemiparesis from a midbrain mass . Ann Neurol 1981;;9:405-407.
16 +
Garcin R, Lapresle J:  Incoordination cérébelleuse du membre inférieur par lésion localisée de la région interne du thalamus contralatéral . Rev Neurol 1969;;120:5-13.
17 +
Martin JJ:  Sémiologie et neuropathologie thalamiques humaines . Acta Neurol Belg 1970;; 70:771-794.
18 +
Fisher CM:  Pure sensory stroke involving face, arm, and leg . Neurology 1965;;15:76-80.
19 +
Fisher CM:  Thalamic pure sensory stroke: A pathologic study . Neurology 1978;;28:1141-1144.
20 +
Castaigne P, Lhermitte F, Buge A, et al:  Paramedian thalamic and midbrain infarcts: Clinical and neuropathological study . Ann Neurol 1980;;10:127-148.
21 +
Bogousslavsky J, Regli F, Schneider C:  Les ramollissements dans le territoire de l'artère cérébrale postérieure: Syndromes cliniques, manifestations initiales, facteurs de risque: Etude de 50 cas . Med Hyg 1981;;39:3469-3478.
22 +
Mohr JP:  Lacunes . Stroke 1982;;13:3-11.
23 +
Garcin R:  Syndrome cérébellothalamique par lésion localisée du thalamus: Avec une digression sur le 'signe de la main creuse' et son intérêt sémiologique . Rev Neurol 1955;;93:143-149.
24 +
Foix C, Hillemand P:  Les syndromes de la région thalamique . Presse Med 1925;;33:113-117.
25 +
Garcin R, Lapresle J:  Deuxième observation personnelle de syndrome sensitif de type thalamique par lésion localisée du thalamus . Rev Neurol 1960;;103:474-481.
26 +
Caplan LAR: ' Top of the basilar' syndrome . Neurology 1980;;30:72-79.
27 +
Mohr JP, Kase CS, Meckler RJ, et al:  Sensorimotor stroke due to thalamocapsular ischemia . Arch Neurol 1977;;34:739-741.
28 +
Benson DF, Tomlinson EB:  Hemiplegic syndrome of the posterior cerebral artery . Stroke 1971;;2:559-564.

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1 +
Fisher CM:  Ataxic hemiparesis . Arch Neurol 1978;;35:126-128.
2 +
Fisher CM, Cole M:  Homolateral ataxia and crural paresis: A vascular syndrome . J Neurol Neurosurg Psychiatry 1965;;28:48-55.
3 +
Perman GP, Racy A:  Homolateral ataxia and crural paresis: Case report . Neurology 1980;; 30:1013-1015.
4 +
Sakai T, Murakami S, Ito K:  Ataxic hemiparesis with trigeminal weakness . Neurology 1981;;31:635-636.
5 +
Ichikawa K, Tsutsumushita A, Fujioka A:  Capsular ataxic hemiparesis . Arch Neurol 1982;; 39:585-586.
6 +
Iragui VJ, McCutchen CB:  Capsular ataxic hemiparesis . Arch Neurol 1982;;39:528-529.
7 +
Jokelainen M, Pilke A:  Ataxic hemiparesis . Arch Neurol 1983;;40:326.
8 +
Tredici G, Bogliun G, Sanguineti I:  Capsular ataxic hemiparesis . Arch Neurol 1983;;40:326.
9 +
De Renzi E, Nichelli P, Crisi G:  Hemiataxia and crural hemiparesis following capsular infarct . J Neurol Neurosurg Psychiatry 1983;; 46:561-563.
10 +
Pullicino P, Nelson RF, Kendall BE, et al:  Small deep infarcts diagnosed on computed tomography . Neurology 1980;;30:1090-1096.
11 +
Weisberg LA:  Lacunar infarcts: Clinical and computed tomographic correlations . Arch Neurol 1982;;39:37-40.
12 +
Donnan GA, Tress BM, Bladin PF:  A prospective study of lacunar infarction using computerized tomography . Neurology 1982;;32:49-56.
13 +
Radhakrishnan K, Malhotra AK, Shridharan R, et al:  Ataxic hemiparesis: Clinical, electrophysiologic, radiologic and pathologic observations . Clin Neurol Neurosurg 1982;;84:91-100.
14 +
Schnapper RA:  Pontine hemorrhage presenting as ataxic hemiparesis . Stroke 1982;; 13:518-519.
15 +
Bendheim PE, Berg BO:  Ataxic hemiparesis from a midbrain mass . Ann Neurol 1981;;9:405-407.
16 +
Garcin R, Lapresle J:  Incoordination cérébelleuse du membre inférieur par lésion localisée de la région interne du thalamus contralatéral . Rev Neurol 1969;;120:5-13.
17 +
Martin JJ:  Sémiologie et neuropathologie thalamiques humaines . Acta Neurol Belg 1970;; 70:771-794.
18 +
Fisher CM:  Pure sensory stroke involving face, arm, and leg . Neurology 1965;;15:76-80.
19 +
Fisher CM:  Thalamic pure sensory stroke: A pathologic study . Neurology 1978;;28:1141-1144.
20 +
Castaigne P, Lhermitte F, Buge A, et al:  Paramedian thalamic and midbrain infarcts: Clinical and neuropathological study . Ann Neurol 1980;;10:127-148.
21 +
Bogousslavsky J, Regli F, Schneider C:  Les ramollissements dans le territoire de l'artère cérébrale postérieure: Syndromes cliniques, manifestations initiales, facteurs de risque: Etude de 50 cas . Med Hyg 1981;;39:3469-3478.
22 +
Mohr JP:  Lacunes . Stroke 1982;;13:3-11.
23 +
Garcin R:  Syndrome cérébellothalamique par lésion localisée du thalamus: Avec une digression sur le 'signe de la main creuse' et son intérêt sémiologique . Rev Neurol 1955;;93:143-149.
24 +
Foix C, Hillemand P:  Les syndromes de la région thalamique . Presse Med 1925;;33:113-117.
25 +
Garcin R, Lapresle J:  Deuxième observation personnelle de syndrome sensitif de type thalamique par lésion localisée du thalamus . Rev Neurol 1960;;103:474-481.
26 +
Caplan LAR: ' Top of the basilar' syndrome . Neurology 1980;;30:72-79.
27 +
Mohr JP, Kase CS, Meckler RJ, et al:  Sensorimotor stroke due to thalamocapsular ischemia . Arch Neurol 1977;;34:739-741.
28 +
Benson DF, Tomlinson EB:  Hemiplegic syndrome of the posterior cerebral artery . Stroke 1971;;2:559-564.

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