Ghika J, Bogousslavsky J, Uske A, Regli F
Service de Neurologie, CHUV, Lausanne, Switzerland.
J Neurol Neurosurg Psychiatry. 1995 Nov;59(5):531-3. doi: 10.1136/jnnp.59.5.531.
A patient with acute onset "classic" cerebellar ataxia of the right arm without clinically detectable deep sensory loss is reported, in relation to an acute posterior parietal infarct. Wild back and forth swaying of the arm, giving away, or worsening by suppression of vision were not seen. The lesion involved area 5, parts of area 7, the angular gyrus, the middle and posterior parieto-occipital gyri, and posterior parts of the superior and middle temporal gyri. The paracentral lobule, commonly thought to be responsible for parietal ataxia, was spared. Thus posterior parietal lesions can mimick cerebellar ataxia, possibly by severing specific projections to the ventrolateral thalamic nuclei. On the basis of previous studies in primates, the superior parietal gyrus may play a major part in the ataxia presented by this patient.
报告了一名急性起病的右臂“典型”小脑性共济失调患者,临床上未检测到深度感觉丧失,与急性顶叶后梗死有关。未观察到手臂来回剧烈摆动、共济失调性倾倒或因视觉抑制而加重的情况。病变累及5区、7区部分、角回、顶枕中回和后回以及颞上回和颞中回后部。通常认为负责顶叶共济失调的中央旁小叶未受累。因此,顶叶后部病变可能通过切断至腹外侧丘脑核的特定投射来模仿小脑性共济失调。根据先前对灵长类动物的研究,顶上小叶可能在该患者出现的共济失调中起主要作用。