title: Same or opposite? Association of head-movement weakness with limb paresis in stroke.
abstract: OBJECTIVE
  The precise innervation of the sternocleidomastoids is uncertain. Of clinical interest is whether a unilateral hemispheric lesion leads to an ispilateral or contralateral sternocleidomastoid weakness.
  
  
  METHODS
  Sternocleidomastoid strength was assessed in 124 consecutive acute stroke patients during yaw, pitch, and roll head movements. This was correlated with limb paresis and neuroimaging findings.
  
  
  RESULTS
  The incidence and the degree of sternocleidomastoid paresis were low (16.9%). In all cases, head rotation weakness away from the affected hemisphere was observed. Lateral tilt and vertical head rotations were unaffected. No weakness was detected in lesions that did not cause manifest limb paresis.
  
  
  CONCLUSIONS
  Our data point to an ipsihemispheric sternocleidomastoid control. Sternocleidomastoid paresis in stroke is expected only with concomitant limb paresis and is always less severe. Head tilt is not affected probably due to sparing of ancillary neck-muscle function.
authors: Department of Neurology, Eginition Hospital, University of Athens, Vas. Sophias Avenue 74, Athens, Greece. granavan@yahoo.com
authors: Evangelos
authors: E
authors: Anagnostou
authors: Georgios P
authors: GP
authors: Paraskevas
authors: Konstantinos
authors: K
authors: Spengos
authors: Sophia
authors: S
authors: Vassilopoulou
authors: Vasileios
authors: V
authors: Zis
authors: Dimitrios
authors: D
authors: Vassilopoulos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019416:Head Movements / Q000502:physiology*; D006801:Humans; D008875:Middle Aged; D018908:Muscle Weakness / Q000209:etiology* / Q000503:physiopathology*; D009334:Neck Muscles / Q000503:physiopathology*; D010291:Paresis / Q000150:complications* / Q000209:etiology / Q000503:physiopathology*; D020521:Stroke / Q000150:complications / Q000503:physiopathology*