Pitfalls in the diagnosis of pupil-sparing oculomotor nerve palsy without limb ataxia: a case report of a variant of Claude’s syndrome and neuroanatomical analysis using diffusion-tensor imaging.
Pitfalls in the diagnosis of pupil-sparing oculomotor nerve palsy without limb ataxia: a case report of a variant of Claude’s syndrome and neuroanatomical analysis using diffusion-tensor imaging.
复制标题
诊断不伴有肢体共济失调的保留瞳孔动眼神经麻痹的陷阱：克劳德综合征变体的病例报告和使用弥散张量成像的神经解剖学分析。
DOI：
10.1016/j.jocn.2017.09.027
复制
发表时间：
2018
期刊：
影响因子：
2
通讯作者：
Machida A.
中科院分区：
文献类型：
--
作者：
Amano E;Komatsuzaki T;Ishido H;Ishihara T;Otsu S;Yamada I;Machida A.
中脑梗塞引起的动眼神经麻痹伴对侧共济失调被命名为克劳德综合征。在此，我们报告了克劳德综合征的一种变体的情况下，它显示瞳孔保留动眼神经麻痹没有伴随的神经缺陷，除了微妙的躯干共济失调。MRI和弥散张量成像显示，中脑梗死位于小脑上足部（SCP）顶侧上方，可能部分破坏了构造脊髓束，导致肢体共济失调缺失和轻微的躯干共济失调。由于患者步态明显正常，仅表现为不稳定的串联步态，故应谨慎评估其躯干性共济失调，以免误诊为孤立性保瞳孔动眼神经麻痹。
Midbrain infarction causing oculomotor nerve palsy with contralateral ataxia is named Claude’s syndrome. Herein we report the case of a variant of Claude’s syndrome, which shows pupil-sparing oculomotor nerve palsy without the accompanying neurological deficits other than subtle truncal ataxia. MRI and Diffusion Tensor Imaging revealed that midbrain infarction was located rostrally above the decussation of the superior cerebellar peduncle (SCP) and might have partially destructed the tectospinal tract, which resulted in the absence of limb ataxia and presence of subtle truncal ataxia. In this variant of Claude’s syndrome, we should carefully assess truncal ataxia to avoid misdiagnosing it as isolated pupil-sparing oculomotor nerve palsy because the patient showed apparently normal gait and truncal ataxia was only revealed by unstable tandem gait.