Misumi Youhei, Nishida Yasuto, Araki Shukuro
Department of Neurology, Omuta Tenryo Hospital.
Rinsho Shinkeigaku. 2006 Sep;46(9):649-51.
We report a 82-year-old woman who developed difficulty in standing and sitting in the morning. She had no other complaints and stayed in the bed. The next day, she was admitted to the hospital and neurological examination revealed that she was alert, with no other motor or sensory abnormalities. Finger to nose test, and knee to heel test were normal. No dysdiadochokinesia was seen. Astasia was the only observed abnormal finding. MRI showed a small infarction (14 x 8mm) in the posterolateral portion of the left thalamus (VPL-LP nucleus). During the following 15 days, her imbalance has gradually improved and then disappeared. We diagnosed the patient as astasia occurring from a small unilateral infarction in the thalamus. It is thought that thalamic astasia is caused by the disruption of afferent pathway from the vestibulocerebellum; however, this case is based on just clinical and MRI study, so physiological and pathological studies will be necessary in the future.
我们报告一名82岁女性，她早晨出现站立和坐下困难。她无其他不适，卧床休息。次日，她入院，神经系统检查显示意识清醒，无其他运动或感觉异常。指鼻试验和跟膝胫试验正常。未见轮替运动障碍。静止不能是唯一观察到的异常发现。MRI显示左侧丘脑后外侧部分（腹后外侧核-外侧核）有一个小梗死灶（14×8mm）。在接下来的15天里，她的平衡障碍逐渐改善然后消失。我们将该患者诊断为丘脑小的单侧梗死导致的静止不能。据认为，丘脑性静止不能是由前庭小脑传入通路中断引起的；然而，该病例仅基于临床和MRI研究，因此未来有必要进行生理和病理研究。
