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HOME > J Korean Bal Soc > Volume 5(2); 2006 > Article
Original Article Body Lateropulsion as an Isolated or Predominant Symptom of a Pontine Infarction
Hyun Ah Kim, Hyung Lee, Byung Rim Park

DOI: https://doi.org/
1Department of Neurology, Keimyung University School of Medicine, Daegu, Korea. hlee@dsmc.or.kr
2Brain Research Institute, Keimyung University School of Medicine, Daegu, Korea.
3Department of Physiology, Wonkwang University School of Medicine, Iksan, Korea.
4Medicine and Hanbang Brain Disease Research Center, Wonkwang University School of Medicine, Iksan, Korea.
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Background
and Objectives: Body lateropulsion with falling to one side is a well-known clinical feature of stroke in the posterior circulation. Body lateropulsion as an isolated or predominant manifestation of a pontine stroke has not previously been reported. To elucidate the possible mechanisms of patients presenting with body lateropulsion as an isolated or predominant symptom of isolated pontine infarction. Materials and Method: Between May 2004 and February 2006, out of 134 admitted patients with an isolated pontine stroke we identified 8 consecutive patients (6.0%) in the Keimyung University Stroke Registry who had body lateropulsion as the main presenting symptom.
Results
All lesions were localized to the paramedian tegmentum just ventral to the 4th ventricle. All except 1showed a uniform pattern of body lateropulsion, in which the direction of falling was away from the side of infarct. In 2 patients, body lateropulsion was the sole clinical manifestation, whereas the other patients had other neurological signs. All but 1 had contraversive tilting of the subjective visual vertical (SVV). In all cases, the direction of SVV tilt corresponded to the direction of body lateropulsion. The mean net tilt angle was 6.1
Conclusion
Based on the known anatomy of ascending vestibular pathways, the SVV tilting, and MRI findings, body lateropulsion probably results from damage to the graviceptive pathway ascending through paramedian pontine tegmentum. Key Words : Pons, Infarction


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