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一名下外侧延髓梗死患者的同侧下肢共济失调：运动分析及身体侧倾的可能机制

Ipsilateral Lower Limb Ataxia in a Patient with Lower Lateral Medullary Infarction: A Motion Analysis and the Possible Mechanism of Body Lateropulsion.

作者信息

Naoi Tameto, Mashiko Takafumi, Fujimoto Shigeru, Morita Mitsuya

机构信息

Rehabilitation Center, Jichi Medical University Hospital, Japan.

Division of Neurology, Department of Medicine, Jichi Medical University, Japan.

出版信息

Intern Med. 2025 Apr 15;64(8):1253-1257. doi: 10.2169/internalmedicine.4151-24. Epub 2024 Sep 18.

DOI:10.2169/internalmedicine.4151-24
PMID:39293980
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12097824/
Abstract

A 69-year-old man was admitted to our hospital because of a sudden gait disturbance. Based on the neurological examination performed upon admission, the patient exhibited ataxic movement in his right lower limb and body lateropulsion toward the right side. Magnetic resonance imaging revealed a lower lateral medullary infarction limited to the lateral surface. A motion analysis revealed ipsilateral lower-limb ataxia. Lower lateral medullary infarction can cause ipsilateral lower limb ataxia, particularly impaired hip joint coordination, resulting in body lateropulsion in dynamic conditions.

摘要

一名69岁男性因突然出现步态障碍入院。根据入院时进行的神经学检查，患者右下肢出现共济失调运动，身体向右侧偏斜。磁共振成像显示局限于外侧表面的延髓下外侧梗死。运动分析显示同侧下肢共济失调。延髓下外侧梗死可导致同侧下肢共济失调，尤其是髋关节协调受损，在动态情况下导致身体偏斜。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b60/12097824/f8920a70fe7b/1349-7235-64-1253-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b60/12097824/37a259015009/1349-7235-64-1253-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b60/12097824/8145b376c315/1349-7235-64-1253-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b60/12097824/89e7ac456720/1349-7235-64-1253-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b60/12097824/f8920a70fe7b/1349-7235-64-1253-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b60/12097824/37a259015009/1349-7235-64-1253-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b60/12097824/8145b376c315/1349-7235-64-1253-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b60/12097824/89e7ac456720/1349-7235-64-1253-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b60/12097824/f8920a70fe7b/1349-7235-64-1253-g004.jpg

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本文引用的文献

1
Body Lateropulsion in Stroke: Case Report and Systematic Review of Stroke Topography and Outcome.脑卒中患者的体轴侧方移位：病例报告和脑卒中解剖与结局的系统评价。
J Stroke Cerebrovasc Dis. 2021 May;30(5):105680. doi: 10.1016/j.jstrokecerebrovasdis.2021.105680. Epub 2021 Feb 27.
2
Clinical Characteristics and Clinical Course of Body Lateropulsion in 47 Patients with Brainstem Infarctions.47 例脑干梗死患者的体侧推力的临床特征和临床病程。
J Stroke Cerebrovasc Dis. 2020 Oct;29(10):105183. doi: 10.1016/j.jstrokecerebrovasdis.2020.105183. Epub 2020 Aug 4.
3
Isolated body lateropulsion caused by lower lateral medullary infarction.
下外侧延髓梗死所致的孤立性身体侧推症
eNeurologicalSci. 2017 Mar 27;7:25-26. doi: 10.1016/j.ensci.2017.03.004. eCollection 2017 Jun.
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Horner syndrome: clinical perspectives.霍纳综合征：临床视角
Eye Brain. 2015 Apr 10;7:35-46. doi: 10.2147/EB.S63633. eCollection 2015.
5
Isolated axial lateropulsion with ipsilesional subjective visual vertical tilt in caudal lateral medullary infarction.尾侧延髓外侧梗死伴患侧主观垂直视觉倾斜的孤立性轴向侧推症
J Vestib Res. 2015;25(1):41-5. doi: 10.3233/VES-150543.
6
[Lateral medullary infarction presenting with truncal lateropulsion and decreased pain and temperature sensation below T10 sensory level].[以躯干侧方偏斜及T10感觉平面以下痛温觉减退为表现的延髓外侧梗死]
Rinsho Shinkeigaku. 2014;54(10):819-23. doi: 10.5692/clinicalneurol.54.819.
7
Ocular and truncal lateropulsion associated with caudal lateral medullary infarction.与延髓尾端外侧梗死相关的眼球和躯干侧方推挤
CNS Neurosci Ther. 2012 Feb;18(2):182-4. doi: 10.1111/j.1755-5949.2011.00284.x.
8
Lateropulsion, pushing and verticality perception in hemisphere stroke: a causal relationship?半球卒中中的推挤偏侧、推挤及垂直感知：因果关系？
Brain. 2008 Sep;131(Pt 9):2401-13. doi: 10.1093/brain/awn170. Epub 2008 Aug 4.
9
Lateropulsion due to a lesion of the dorsal spinocerebellar tract.由于脊髓小脑后束病变导致的偏侧推挤。
Intern Med. 2005 Dec;44(12):1295-7. doi: 10.2169/internalmedicine.44.1295.
10
A topodiagnostic investigation on body lateropulsion in medullary infarcts.延髓梗死身体侧推的地形诊断研究。
Neurology. 2005 Feb 22;64(4):716-8. doi: 10.1212/01.WNL.0000152040.27264.1A.