Document Detail

Body lateropulsion as an isolated or predominant symptom of a pontine infarction.
MedLine Citation:
PMID:  17119007     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Lateropulsion of the body--that is, falling to one side--is a well-known clinical feature of stroke in the posterior circulation. Body lateropulsion as an isolated or predominant manifestation of a pontine stroke has not been reported previously. OBJECTIVE: To elucidate the possible mechanisms of patients presenting with body lateropulsion as an isolated or predominant symptom of an isolated pontine infarction. METHODS: Between May 2004 and February 2006, out of 134 patients admitted with an isolated pontine stroke, we identified 8 (6%) consecutive patients in the Keimyung University Stroke Registry who had body lateropulsion as the main presenting symptom. RESULTS: All lesions were localised to the paramedian tegmentum just ventral to the fourth ventricle. All except one showed a uniform pattern of body lateropulsion, in which the direction of falling was away from the side of an infarct. In two patients body lateropulsion was the sole clinical manifestation, whereas the other patients had other neurological signs. All but one patient had contraversive tilting of the subjective visual vertical (SVV). In all cases, the direction of SVV tilt corresponded to the direction of body lateropulsion. The mean net tilt angle was 6.1 degrees. CONCLUSIONS: Based on the known anatomy of ascending vestibular pathways, SVV tilting and MRI findings, it is concluded that body lateropulsion probably results from damage to the graviceptive pathway ascending through the paramedian pontine tegmentum.
Hyon-Ah Yi; Hyun-Ah Kim; Hyung Lee; Robert W Baloh
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2006-11-21
Journal Detail:
Title:  Journal of neurology, neurosurgery, and psychiatry     Volume:  78     ISSN:  1468-330X     ISO Abbreviation:  J. Neurol. Neurosurg. Psychiatr.     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-03-19     Completed Date:  2007-03-29     Revised Date:  2010-09-15    
Medline Journal Info:
Nlm Unique ID:  2985191R     Medline TA:  J Neurol Neurosurg Psychiatry     Country:  England    
Other Details:
Languages:  eng     Pagination:  372-4     Citation Subset:  IM    
Department of Neurology, Keimyung University School of Medicine, 194 Dongsan dong, Daegu 700-712, South Korea.
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MeSH Terms
Accidental Falls*
Aged, 80 and over
Brain Stem / pathology*
Functional Laterality
Magnetic Resonance Imaging
Middle Aged
Stroke / complications*,  physiopathology*
Tegmentum Mesencephali / pathology

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