Co-Occurrence of Astasia and Unilateral Asterixis Caused by Acute Mesencephalic Infarction

Song, In‐Uk; Kim, Joong‐Seok; An, Jae-Young; Kim, Yeong-In; Lee, Kwang-Soo

doi:10.1159/000098061

Cited by 9 publications

(14 citation statements)

References 11 publications

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“…The authors stated that astasia might be caused by impairment of the fastigial efferent fibers at the pedunculopontine area . Song et al . noted a case of astasia and unilateral asterixis secondary to midbrain infarction.…”

Section: Discussionmentioning

confidence: 99%

“…Astasia designates motor incoordination with inability to stand, despite good strength . Because astasia is a rare symptom, its pathogenesis remains uncertain.…”

Section: Introductionmentioning

confidence: 99%

“…Because astasia is a rare symptom, its pathogenesis remains uncertain. Regarding responsible region for astasia, the thalamus, thalamo‐mesencephalic junction, mesencephalon, pontomesencephalic locomotor region, posterior cingulate gyrus, and supplementary motor area were reported (Table ). We herein describe a first reported case of isolated astasia due to a suprathalamic white matter infarction.…”

Section: Introductionmentioning

confidence: 99%

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Isolated astasia caused by a localized infarction in the suprathalamic white matter

Takahashi

Osaka

Tsuda

et al. 2017

J of Gen and Family Med

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A 73‐year‐old woman with essential hypertension and diabetes mellitus abruptly developed astasia. There were no other neurological abnormalities. Cranial diffusion‐weighted magnetic resonance imaging demonstrated a localized infarction in the right‐sided suprathalamic white matter. Under antiplatelet agent and rehabilitation, the patient became asymptomatic within 4 days. This is a first reported case of isolated astasia due to a suprathalamic white matter infarction. We speculated that disruption of the connection from the ventrolateral nucleus of the thalamus to the posterior cingulate gyrus and/or supplementary motor area might cause astasia.

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Section: Discussionmentioning

confidence: 99%

“…Astasia designates motor incoordination with inability to stand, despite good strength . Because astasia is a rare symptom, its pathogenesis remains uncertain.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Isolated astasia caused by a localized infarction in the suprathalamic white matter

Takahashi

Osaka

Tsuda

et al. 2017

J of Gen and Family Med

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“…Masdeu and Gorelick [1] first systematically described 15 patients with astasia caused by unilateral thalamic lesion (also called ‘thalamic astasia’). The mesencephalon [4] or the pontomesencephalic locomotor region [5] was also reported as a responsible lesion for astasia. In patients with the so-called ‘thalamic astasia,’ the superior portion of the ventrolateral nucleus (VL) of the thalamus was mainly involved.…”

Section: Discussionmentioning

confidence: 99%

“…This rare symptom has been reported in association with stroke involving the thalamus [1, 2, 3], mesencephalon [4] or the pontomesencephalic locomotor region [5]. Apart from the lesion of the above-mentioned deep structures, the involvement of the cerebral cortex is rarely reported in association with astasia.…”

Section: Introductionmentioning

confidence: 99%

Caudal Cingulate Infarction Manifesting Astasia

Satow¹,

Komuro²,

Kobayashi³

2014

Case Rep Neurol

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Introduction: Astasia is a rare presenting symptom of stroke, usually known as ‘thalamic astasia', induced by a lesion in the ventrolateral thalamus. We report a case of caudal cingulate infarction manifesting astasia. Case Presentation: A 58-year-old male presented with inability to sit, stand and walk (astasia). No apparent motor weakness was noticed in the extremities. MRI revealed cerebral infarction in the caudal cingulate gyrus, which was located between the vertical commissure anterior (VCA) line and vertical commissure posterior (VPC) line. His symptoms persisted for 1 year to a lesser degree. Conclusion: Lesions in the caudal cingulate gyrus can present with astasia. The responsible lesion is located in the cingulate gyrus between the VCA and VPC line, which might correspond to the caudal cingulate zone in humans. We should keep in mind that astasia can be a presenting symptom of stroke.

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Asterixis: a study of 103 patients

2014

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In 1949, asterixis was first described in patients with hepatic encephalopathy. It was quickly recognized that this phenomenon also occurs in other generalized encephalopathies and sometimes results from structural brain lesions. This paper is a study of asterixis in the general neurology clinic and on the inpatient neurology consultation service. The neurologists recorded the findings on inpatients and clinic patients for 12 consecutive months. Of the 1,109 inpatients with adequate examination, asterixis was documented in 97. Eighteen of the 97 cases were unilateral (18.6%) and 79 cases were bilateral (81.4%). Of the 614 outpatient visits with well documented examination, 6 (1%) individuals had asterixis. Since a small number of patients were examined more than once, the study yielded 103 individuals with adequate data for analysis. Asterixis resulted from varied causes: medications, renal disorder, hepatic dysfunction, pulmonary insufficiency, stroke and other brain lesions (including malignancy, subdural hematoma, and epidural abscess). Asterixis occurred in various patterns: in some cases it was easier to elicit in the upper extremities, in some it was easier to elicit in the lower limbs, and some it was solely or predominantly unilateral. The findings are discussed in light of the literature on asterixis with regard to its varied causes, patterns and presentations. Lastly, asterixis is examined from a historical perspective and the terminology is elucidated.

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Co-Occurrence of Astasia and Unilateral Asterixis Caused by Acute Mesencephalic Infarction

Cited by 9 publications

References 11 publications

Isolated astasia caused by a localized infarction in the suprathalamic white matter

Isolated astasia caused by a localized infarction in the suprathalamic white matter

Caudal Cingulate Infarction Manifesting Astasia

Asterixis: a study of 103 patients

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