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Neurological Sciences

, Volume 37, Issue 6, pp 979–981 | Cite as

Asterixis in the leg induced by anterior cerebral artery infarction

  • Mun Kyung Sunwoo
  • Hyun-soon Jang
  • Sook Young Roh
  • Hyun Jung Yoo
  • Eun Hye Jeong
  • Byung-Su Kim
  • Yeo Reum Choe
  • Ko-Eun LeeEmail author
Brief Communication

Abstract

Asterixis commonly occurs in a patient with metabolic encephalopathy, whereas focal brain lesions such as thalamus, cerebellum, or frontal area also cause focal or unilateral asterixis in the arms. We report a novel case of asterixis in the leg after unilateral anterior cerebral artery territory infarction. A 76-year-old man was admitted with sudden-onset mild right leg weakness and postural instability due to knee buckling. He was diagnosed with ischemic stroke in the left prefrontal area and cingulated gyrus by brain magnetic imaging. Needle electromyography of the right vastus lateralis muscle while standing showed intermittent periods of EMG silence, consistent with asterixis. There were no abnormal involuntary movements in the upper extremities. This case suggests that gait disturbance or postural instability after structural lesions in the prefrontal area may be directly related to asterixis in the leg, not in the arm associated with postural failure.

Keywords

Movement disorder Asterixis Anterior cerebral artery territory infarction Prefrontal 

Notes

Compliance with ethical standards

Conflict of interest

Nothing to report.

Supplementary material

Video 1. The video shows the patients with asterixis in the right leg (MP4 18329 kb)

10072_2016_2486_MOESM2_ESM.mp4 (4.2 mb)
Video 2. The video demonstrated the needle electromyography (EMG) of right vastus lateralis muscle showing intermittent periods of EMG silence (MP4 4289 kb)

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Copyright information

© Springer-Verlag Italia 2016

Authors and Affiliations

  • Mun Kyung Sunwoo
    • 1
  • Hyun-soon Jang
    • 1
  • Sook Young Roh
    • 1
  • Hyun Jung Yoo
    • 1
  • Eun Hye Jeong
    • 1
  • Byung-Su Kim
    • 1
  • Yeo Reum Choe
    • 2
  • Ko-Eun Lee
    • 2
    Email author
  1. 1.Department of NeurologyBundang Jesaeng General HospitalSeongnamSouth Korea
  2. 2.Department of RehabilitationBundang Jesaeng General HospitalSeongnamSouth Korea

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