Letter to the Editor| Volume 352, ISSUE 1-2, P107, May 15, 2015

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Appendicular ataxia without position sense loss in a patient with parietal lobe infarct

Published:March 18, 2015DOI:
      A 86-year-old lady presented with sudden onset of appendicular ataxia of the right arm with minimal weakness and no deep sensory loss. On neurological exam, she had minimal pronator drift. She had undershooting and overshooting on attempting to reach the target finger on finger to nose test. She also has dysdiadokokinesia and uncontrolled rebound. The tests were not worsened with eyes closed. The sensory exam was unremarkable including normal proprioception. Her brain MRI showed an area of acute infarct in left posterior parietal lobe (Fig. 1) and no other lesion. Although parietal ataxia is generally considered to result from loss of proprioceptive feedback inputs to the motor function [
      • Ghika J.
      • Bogousslavsky J.
      • Uske A.
      • Regli F.
      Parietal kinetic ataxia without proprioceptive deficit.
      ], but our patient showed clinical features of classic cerebellar kinetic ataxia without loss of proprioception. Brain MRI showed involvement of superior and part of inferior parietal lobules with preserving paracentral lobule which is presumably responsible for sensory innervation of contralateral limbs.
      Figure thumbnail gr1
      Fig. 1Brain MRI diffusion weighted image shows diffusion restriction in the left posterior parietal lobe consistent with acute to subacute infarct.


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