title: Asterixis in the leg induced by anterior cerebral artery infarction.
abstract: Asterixis commonly occurs in a patient with metabolic encephalopathy, whereas focal brain lesions such as thalamus, cerebellum, or frontal area also cause focal or unilateral asterixis in the arms. We report a novel case of asterixis in the leg after unilateral anterior cerebral artery territory infarction. A 76-year-old man was admitted with sudden-onset mild right leg weakness and postural instability due to knee buckling. He was diagnosed with ischemic stroke in the left prefrontal area and cingulated gyrus by brain magnetic imaging. Needle electromyography of the right vastus lateralis muscle while standing showed intermittent periods of EMG silence, consistent with asterixis. There were no abnormal involuntary movements in the upper extremities. This case suggests that gait disturbance or postural instability after structural lesions in the prefrontal area may be directly related to asterixis in the leg, not in the arm associated with postural failure.
authors.affiliation: Department of Neurology, Bundang Jesaeng General Hospital, Seongnam, South Korea.
authors.forename: Mun Kyung
authors.initials: MK
authors.lastname: Sunwoo
authors.affiliation: Department of Neurology, Bundang Jesaeng General Hospital, Seongnam, South Korea.
authors.forename: Hyun-Soon
authors.initials: HS
authors.lastname: Jang
authors.affiliation: Department of Neurology, Bundang Jesaeng General Hospital, Seongnam, South Korea.
authors.forename: Sook Young
authors.initials: SY
authors.lastname: Roh
authors.affiliation: Department of Neurology, Bundang Jesaeng General Hospital, Seongnam, South Korea.
authors.forename: Hyun Jung
authors.initials: HJ
authors.lastname: Yoo
authors.affiliation: Department of Neurology, Bundang Jesaeng General Hospital, Seongnam, South Korea.
authors.forename: Eun Hye
authors.initials: EH
authors.lastname: Jeong
authors.affiliation: Department of Neurology, Bundang Jesaeng General Hospital, Seongnam, South Korea.
authors.forename: Byung-Su
authors.initials: BS
authors.lastname: Kim
authors.affiliation: Department of Rehabilitation, Bundang Jesaeng General Hospital, 20, Seohyun-ro 180, Bundang gu, Seongnam, Kyunggo-do, 463-774, South Korea.
authors.forename: Yeo Reum
authors.initials: YR
authors.lastname: Choe
authors.affiliation: Department of Rehabilitation, Bundang Jesaeng General Hospital, 20, Seohyun-ro 180, Bundang gu, Seongnam, Kyunggo-do, 463-774, South Korea. rhsrhs2u@gmail.com.
authors.forename: Ko-Eun
authors.initials: KE
authors.lastname: Lee
mesh_terms: D000368:Aged; D056324:Diffusion Tensor Imaging; D020820:Dyskinesias / Q000000981:diagnostic imaging / Q000209:etiology*; D004576:Electromyography; D019054:Evoked Potentials, Motor / Q000502:physiology; D006801:Humans; D020243:Infarction, Anterior Cerebral Artery / Q000150:complications* / Q000000981:diagnostic imaging; D007866:Leg / Q000503:physiopathology*; D008297:Male
keywords: Anterior cerebral artery territory infarction; Asterixis; Movement disorder; Prefrontal