title: Fluctuating locked-in syndrome as a presentation of a bilateral pontine infarction.
abstract: The "pontine warning syndrome" is characterized by recurrent episodes of motor hemiparesis, dysarthria and horizontal gaze palsy associated with basilar artery branch infarction. We report a case of a patient who presented with recurrent, self-limited episodes of locked-in syndrome, related to a bilateral pontine infarction. As far as we know, this clinical presentation as a subtype of pontine warning syndrome has never been described. We discuss the case, the differential diagnosis of the neuroimaging and the possible underlying mechanism.
authors.affiliation: Acute Stroke Unit, Department of Neurosciences, Hospital Universitari Germans Trias i Pujol, Spain carlosgesperon@yahoo.es.
authors.forename: Carlos
authors.initials: C
authors.lastname: García-Esperón
authors.affiliation: Acute Stroke Unit, Department of Neurosciences, Hospital Universitari Germans Trias i Pujol, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: López-Cancio
authors.affiliation: Acute Stroke Unit, Department of Neurosciences, Hospital Universitari Germans Trias i Pujol, Spain.
authors.forename: Lorena
authors.initials: L
authors.lastname: Martín-Aguilar
authors.affiliation: Acute Stroke Unit, Department of Neurosciences, Hospital Universitari Germans Trias i Pujol, Spain.
authors.forename: Mónica
authors.initials: M
authors.lastname: Millán
authors.affiliation: Interventional Neuroradiology Unit, Hospital Universitari Germans Trias i Pujol, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Castaño
authors.affiliation: MRI Unit, Institut de Diagnòstic per la Imatge (IDI), Hospital Universitari Germans Trias i Pujol, Spain.
authors.forename: Josep
authors.initials: J
authors.lastname: Munuera
authors.affiliation: Acute Stroke Unit, Department of Neurosciences, Hospital Universitari Germans Trias i Pujol, Spain.
authors.forename: Antoni
authors.initials: A
authors.lastname: Dávalos
mesh_terms: D020520:Brain Infarction / Q000473:pathology* / Q000503:physiopathology* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D059906:Neuroimaging; D015835:Ocular Motility Disorders / Q000150:complications* / Q000000981:diagnostic imaging; D010291:Paresis / Q000209:etiology*; D011149:Pons / Q000000981:diagnostic imaging / Q000473:pathology*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use
chemical_list: D010959:Tissue Plasminogen Activator
keywords: Stroke; capsular warning syndrome; locked-in; pontine warning syndrome