Rehabilitation of the Pontine Ataxia-Dysmetria Syndrome

PM R. 2017 Jun;9(6):636-638. doi: 10.1016/j.pmrj.2017.01.001. Epub 2017 Jan 16.

Abstract

We present a case of a patient with significant ataxia and dysmetria following a lacunar pontine infarction and review the literature on this uncommon syndrome. The patient had an excellent clinical course with near resolution of symptoms and signs in less than 3 weeks. We illustrate the patient's ataxia and dysmetria with videos and also use the videos to demonstrate and characterize the features of the dysmetria. Interestingly, the characteristics of the dysmetria appear to be different from those seen in patients with dysmetria arising from a cerebellar or thalamic lesion. We discuss the likely neurophysiologic mechanisms responsible for the condition and recovery. Simple noninvasive study of patients with ataxia and dysmetria secondary to a pontine lacunar infarct may be most helpful in elucidating the contribution of pontocerebellar fibers to motor control.

Level of evidence: V.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Cerebellar Ataxia / etiology
  • Cerebellar Ataxia / physiopathology
  • Cerebellar Ataxia / rehabilitation*
  • Cerebral Infarction / complications
  • Cerebral Infarction / diagnostic imaging*
  • Exercise Therapy / methods
  • Female
  • Follow-Up Studies
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Middle Aged
  • Occupational Therapy*
  • Physical Therapy Modalities*
  • Syndrome
  • Treatment Outcome