Gutiérrez-Castillo A, Jiménez-Ruiz A, Gutiérrez-Castillo J, Ruiz-Sandoval JL

Language: Spanish
References: 5
Page: 619-622
PDF size: 218.44 Kb.

ABSTRACT

Background: The lacunar dysarthria-clumsy hand syndrome was described by Miller-Fisher in 1967. Although other pathophysiological mechanisms, such as atherothrombotic or embolic infarction have been described, the lacunar hypothesis originally described by Miller-Fisher remains as the main mechanism in this syndrome.
Clinical case: A 59-year-old female patient with history of hypertension who suddenly developed dysarthria-clumsy hand syndrome as a result of a lacunar infarction in the left internal capsule, secondary to a hypertensive emergency. After management of blood pressure, neurologic symptoms disappeared, with an excellent prognosis in short and medium term.
Conclusions: Compared to other ischemic strokes, a more favorable prognosis has been described in lacunar strokes. In those presenting as dysarthria-clumsy hand syndrome mortality is very low with excellent prognosis.

REFERENCES

1. Arboix A, Martí-Vilalta JL. Lacunar stroke. Expert Rev Neurother 2009; 9: 179-96. doi. 10.1586/14737175.9.2.179.

2. Reggenhardt RW, Das AS, Lo EH, Caplan LR. Advances in understanding the pathophysiology of lacunar stroke: A review. JAMA Neurol 2018; 75: 1273-81. doi. 10.1001/ jamaneurol.2018.1073.

3. Arboix A, Bell Y, García-Eroles L, Massons J, et al. Clinical study of 35 patients with dysarthria-clumsy hand syndrome. J Neurol Neurosurg Psychiatry 2004;75:231-4.

4. Urban PP, Hopf HC, Visbeck A, Fleischer S, Andreas J. Dysarthria-clumsy hand syndrome due to infarction of the cerebral peduncle. J Neurol Neurosurg Psychiatr 1996; 60: 231-32. doi. 10.1136/jnnp.60.2.231-a.

5. Norrving B. Long-term prognosis after lacunar infarction. Lancet Neurol 2003; 2: 238-45. https://doi.org/10.1016/ S1474-4422(03)00352-1.