Boisson D, Confavreux C, Eyssette M, Aimard G, Devic M
Rev Neurol (Paris). 1981;137(12):807-15.
A tonic ambulatory foot response developed one year after clamping of an aneurysm of the contralateral carotid artery in a young adult. No motor deficiency was noted during the postoperative period, but spasm of the carotid bifurcation branches were present on arteriograms. Clinical examination and deep reflexes tests excluded pyramidal lesions. Cortical somatesthetic evoked potential recordings confirmed the absence of sensory disturbances. CT scan suggested the presence of an infarct in the territory of the anterior choroidal artery. The present findings are compared with previous reports. The etiological data and CT scan results in the present case allow reconsideration of the physiopathology of tonic ambulatory foot response in the light of current knowledge of locomotor function in animals. The tonic flexion, an "extension" dystonia of the toes, electively provoked by walking, occurring one year after the neurological accident without any pyramidal signs, could arise from a coordination synkinesis due to lesions limited to the efferent extrapyramidal system.
一名年轻成年人在对侧颈动脉动脉瘤夹闭术后一年出现了强直性动态足部反应。术后期间未发现运动功能缺陷,但动脉造影显示颈动脉分叉分支有痉挛。临床检查和深反射测试排除了锥体束病变。皮层体感诱发电位记录证实没有感觉障碍。CT扫描提示脉络膜前动脉供血区存在梗死灶。将目前的发现与先前的报告进行了比较。本病例的病因学数据和CT扫描结果,使我们能够根据目前对动物运动功能的认识,重新审视强直性动态足部反应的生理病理学。这种强直性屈曲,即脚趾的“伸展”性肌张力障碍,在神经损伤一年后,由行走选择性诱发,且无任何锥体束征,可能源于仅限于传出锥体外系的病变所导致的协同运动。