title: Astasia, asymmetrical asterixis and pretectal syndrome in thalamo-mesencephalic hemorrhage.
abstract: We report a patient who presented with sudden onset instability and diplopia. On neurological examination he had asymmetrical asterixis, predominantly in the left hand, and ocular findings consistent with a pretectal syndrome. He was also unable to stand or even sit up unassisted, with a tendency to tilt his body and rotate his trunk axis to the left. Brain MRI showed a hemorrhage in the right thalamo-mesencephalic junction. This region involves important structures for the control of postural stability, motor control, ocular movements and vestibulo-ocular integration, not yet well understood. To our knowledge, this is the first reported case with the simultaneous combination of astasia, prectectal syndrome and asymmetrical asterixis.
authors.affiliation: Department of Neurology, Hospital Universitario Doce de Octubre, Carretera de Andalucía Km 5,4, 28041 Madrid, Spain. edudepablo@hotmail.com
authors.forename: Eduardo
authors.initials: E
authors.lastname: de Pablo-Fernández
authors.forename: Alberto
authors.initials: A
authors.lastname: Villarejo
authors.forename: Cristina
authors.initials: C
authors.lastname: Domínguez-González
authors.forename: Fernando Sierra
authors.initials: FS
authors.lastname: Hidalgo
authors.forename: Elisa Correas
authors.initials: EC
authors.lastname: Callero
mesh_terms: D004172:Diplopia / Q000150:complications; D020820:Dyskinesias / Q000209:etiology* / Q000523:psychology; D006801:Humans; D020300:Intracranial Hemorrhages / Q000150:complications* / Q000523:psychology; D008297:Male; D008636:Mesencephalon; D008875:Middle Aged; D009460:Neurologic Examination; D013788:Thalamus