Agarwal Ketan, Biswas Ratnadeep, Kumar Vijay
Department of General Medicine, All India Institute of Medical Sciences, Patna, IND.
Cureus. 2023 Mar 1;15(3):e35674. doi: 10.7759/cureus.35674. eCollection 2023 Mar.
Wernekink commissure syndrome (WCS) is an extremely rare midbrain syndrome, in which there is the selective destruction of the decussation of the superior cerebellar peduncle, which commonly presents with bilateral cerebellar signs. We describe a case of WCS with Holmes tremor in a patient having an undiagnosed involuntary movement disorder since childhood following an undocumented case of meningitis. The patient presented with sudden onset gait instability with bilateral cerebellar signs (more prominent on the left side), Holmes tremor in bilateral limbs, slurred speech, and marked dysarthria. No ophthalmoplegia or palatal tremors were noted. The patient was conservatively managed along the lines of a stroke, and there was a marked improvement in cerebellar signs and Holmes tremor with time but no evolution (improvement or worsening) was observed in the involuntary movements of limbs and face that were present before the onset of WCS.
韦尼克交叉综合征（WCS）是一种极为罕见的中脑综合征，其中上小脑脚交叉出现选择性破坏，通常表现为双侧小脑体征。我们描述了一例患有霍姆斯震颤的WCS病例，该患者自童年起患有未确诊的非自愿运动障碍，此前有一例未记录的脑膜炎病例。患者表现为突然发作的步态不稳，伴有双侧小脑体征（左侧更明显），双侧肢体出现霍姆斯震颤，言语含糊，并有明显的构音障碍。未观察到眼肌麻痹或腭部震颤。该患者按照中风的治疗方法进行保守治疗，随着时间推移，小脑体征和霍姆斯震颤有明显改善，但在WCS发作前就已存在的肢体和面部非自愿运动未出现进展（改善或恶化）。
