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Ataxic Hemiparesis

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Handbook of the Cerebellum and Cerebellar Disorders

Abstract

Ataxic hemiparesis (AH) is characterized by the simultaneous presence of a pyramidal tract syndrome with homolateral ataxic syndrome. In the first description of AH by Fisher and Cole (1965), they elaborated the core symptoms as weakness and pyramidal signs on one side combined with ipsilateral cerebellar-like ataxia. However, subsequent reports have expanded the clinical spectrum of AH to include cases with persistent hemisensory deficits and additional symptoms like dysarthria or facial paresis. AH was initially described as a lacunar syndrome correlating with lacunar infarctions. However, recent reports have suggested that AH is not significantly correlated with these infarctions, and in fact a substantial number of studies have demonstrated that lacunar infarction as well as cardioembolic and large-artery atherosclerosis can cause AH. In addition, hemorrhagic strokes, tumors, head trauma, infection, and demyelinating diseases have all been associated with AH. The pons, corona radiata, thalamus, and internal capsule are the most commonly reported lesion sites in AH; however, cortical lesions have also been observed in some AH patients. Regardless of the precipitating insult, specific AH symptoms are thought to result from damage to corticospinal and cerebellar pathways (efferent or afferent), while variations in symptomology reflect the size and precise location of the infarct lesion. Optimal treatment strategies naturally depend on treating the underlying etiology, and to date, have included anticoagulant and antiplatelet drug therapies. The prognosis for AH following ischemic stroke is generally good. This chapter provides an update on the clinical features, lesion topography, treatment, and prognosis of AH.

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Authors and Affiliations

  1. Department of Neurology, Chiba Rosai Hospital, 2-16 Tatsumidai-Higashi, Ichihara-shi, Chiba, 290–0003, Japan

    Dr. Akiyuki Hiraga M.D.

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  1. Dr. Akiyuki Hiraga M.D.
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Correspondence to Akiyuki Hiraga M.D. .

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Editors and Affiliations

  1. Unité d'Etude du Mouvement (UEM), FNRS, Neurologie ULB Erasme, Bruxelles, Belgium

    Mario Manto

  2. Ataxia Unit, Cognitive and Behavioral Neurology Unit, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Jeremy D. Schmahmann

  3. Neuroscience Institute of the Cavalieri-Ottolenghi Foundation (NICO), University of Turin, Orbassano, Turin, Italy

    Ferdinando Rossi

  4. Molecular and Integrative Neuroscience Department (MIND), The Scripps Research Institute, California, CA, USA

    Donna L. Gruol

  5. Department of Integrative Physiolgy, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan

    Noriyuki Koibuchi

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Hiraga, A. (2013). Ataxic Hemiparesis. In: Manto, M., Schmahmann, J.D., Rossi, F., Gruol, D.L., Koibuchi, N. (eds) Handbook of the Cerebellum and Cerebellar Disorders. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-1333-8_74

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