[Cerebellar ataxia and unilateral asterixis caused by thalamic hematoma. Presumed mechanisms].
A 76 year-old hypertensive man developed an acute inability to stand due to a right cerebellar ataxia. Somatosensory performances were normal, but a transient and mild weakness of the right arm and leg with Babinski's sign was observed. There was a prominent asterixis of the right hand. CT scan showed a hemorrhage of the thalamus with surrounding edema of the adjacent internal capsule. Initial median nerve somatosensory evoked potentials showed a mild reduction of left parietal responses with absent left frontal SEPs (P22 and N30). Fourty days later the cerebellar ataxia was persisting while asterixis had disappeared. A second recording of SEPs showed a complete recovery of all cortical components. MRI performed at the same time showed a left postero lateral thalamic lesion. CT, MRI and SEPs findings suggested that asterixis could result from interruption of somatosensory fibres projecting to the motor cortex.
Trouillas
P
P
Service de Neurologie B et Centre de Recherches Cliniques de l'ataxie., Faculté Alexis Carrel, Hôpital Neurologique, Lyon.
Nighoghossian
N
N
Mauguière
F
F
D000368:Aged; D002524:Cerebellar Ataxia / Q000209:etiology* / Q000503:physiopathology; D006406:Hematoma / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D008297:Male; D013786:Thalamic Diseases / Q000150:complications* / Q000503:physiopathology; D014202:Tremor / Q000209:etiology* / Q000503:physiopathology
Syndrome cérébelleux et astérixis unilatéral par hématome thalamique. Mécanismes présumés.