Ipsilateral Tremor-Like Grasp Reaction in a Patient With Ischemic Stroke.
Reports of involuntary ipsilateral movements after a stroke are rare, and none have described a patient with both an instinctive grasp reaction and tremor-like movement ipsilateral to the acute stroke lesion. We here report such a patient. A 76-year-old right-handed woman with a past history of left thalamic hemorrhage developed left hemiparesis, an instinctive grasp reaction, and a peculiar involuntary movement of her right arm. This involuntary movement was stereotyped and sometimes rhythmical, with a groping or picking-like action. The lesion responsible for her motor deficits was a broad infarct in the right internal carotid artery territory. We suggest that her characteristic involuntary tremor-like movement was a variation of the instinctive grasp reaction caused by an ipsilateral ischemic lesion that included the frontal lobe. We illustrate her movements with a video, Supplemental Digital Content 1, http://links.lww.com/CBN/A65.
*Department of Neurology, Saiseikai Kumamoto Hospital †Department of Neurology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
Yuichiro
Y
Inatomi
Makoto
M
Nakajima
Toshiro
T
Yonehara
Yukio
Y
Ando
D000368:Aged; D001132:Arm; D002545:Brain Ischemia / Q000150:complications / Q000523:psychology*; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D002544:Cerebral Infarction / Q000000981:diagnostic imaging; D020820:Dyskinesias; D004569:Electroencephalography; D017809:Fatal Outcome; D005260:Female; D005625:Frontal Lobe / Q000000981:diagnostic imaging; D007839:Functional Laterality; D018737:Hand Strength; D006801:Humans; D008279:Magnetic Resonance Imaging; D010291:Paresis / Q000209:etiology / Q000523:psychology; D013239:Stereotyped Behavior; D020521:Stroke / Q000150:complications / Q000523:psychology*; D014202:Tremor / Q000209:etiology / Q000523:psychology*