The dysarthria-clumsy hand syndrome: a distinct clinical entity related to pontine infarction.
Using magnetic resonance imaging, we studied 6 patients with the dysarthria-clumsy hand syndrome. All were found to have pontine infarctions contralateral to the symptomatic side. Clinically, these patients exhibited dysarthria; "clumsiness," characterized by dysmetria, dysrhythmia, dysdiadochokinesia and sometimes truncal and gait ataxia; and mild ipsilateral weakness. Previous clinical-anatomical correlations for this syndrome are limited by inconsistencies in clinical diagnostic criteria and low-resolution imaging methods. In our patients, and in a review of the literature, the overwhelming majority of patients with the dysarthria-clumsy hand syndrome had pontine infarcts. We conclude that if rigid clinical criteria are used, the label of the dysarthria-clumsy hand syndrome predicts a lesion in the contralateral basis pontis.
Glass
J D
JD
Department of Neurology, Johns Hopkins Hospital, Baltimore, MD 21205.
Levey
A I
AI
Rothstein
J D
JD
D000328:Adult; D000368:Aged; D001259:Ataxia / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D002544:Cerebral Infarction / Q000150:complications* / Q000503:physiopathology; D004401:Dysarthria / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011149:Pons / Q000473:pathology / Q000503:physiopathology*; D013064:Speech Disorders / Q000150:complications*; D013577:Syndrome