Wada Yuko, Nishimura Yo
Department of Neurology, Nishi-Kobe Medical Center, Kobe, Japan.
BMJ Case Rep. 2010 Aug 6;2010:bcr0120102618. doi: 10.1136/bcr.01.2010.2618.
Astasia, which is the inability to stand in the absence of motor weakness or marked sensory loss, is an uncommon clinical feature of stroke in the thalamic ventrolateral region. The authors describe a patient with a unilateral supplementary motor area (SMA) infarction presenting with contralateral astasia. On neurological examination, he would lean to the left side and would fall unless supported. He showed no muscle weakness, sensory deficits or cerebellar ataxia. Magnetic resolution imaging of the brain showed acute infarction only involving the right SMA. On the basis of the anatomy that the SMA is connected to the vestibulocerebellar system through the ventrolateral nucleus of the thalamus, the authors concluded that contralateral astasia probably resulted from disruption of this connection following infarction of the SMA.
站立不能症是指在没有运动无力或明显感觉丧失的情况下无法站立，是丘脑腹外侧区域中风的一种罕见临床特征。作者描述了一名患有单侧辅助运动区（SMA）梗死的患者，表现为对侧站立不能症。神经系统检查时，他会向左倾斜，若不支撑就会摔倒。他没有肌肉无力、感觉缺陷或小脑共济失调。脑部磁共振成像显示急性梗死仅累及右侧SMA。基于SMA通过丘脑腹外侧核与前庭小脑系统相连的解剖结构，作者得出结论，对侧站立不能症可能是由于SMA梗死后这种连接中断所致。
