Ataxic hemiparesis (AH) is a stroke syndrome characterized by a combination of weakness (paresis) and incoordination (ataxia) affecting the same side of the body.
Understanding Ataxic Hemiparesis
| Feature | Description |
|---|---|
| Definition | A clinical syndrome featuring weakness and ataxia occurring on the same side of the body. |
| Key Symptoms | Weakness (paresis) affecting movements. Disproportionate incoordination (ataxia), leading to clumsy or unsteady movements. |
| Historical Context | First described by Fisher in 1965. The definition was broadened in 1978 to encompass any instance of weakness coupled with disproportionate incoordination on the same side of the body. (1,2) |
| Clinical Presentation | Varies, but often includes leg weakness greater than arm weakness, ataxia out of proportion to the weakness, and dysarthria (difficulty speaking). |
| Potential Causes | Small subcortical strokes (lacunar infarcts) are a common cause, often affecting the internal capsule, pons, or corona radiata. Can also result from lesions in other areas of the brain, such as the cerebellum. |
Diagnostic Considerations
Distinguishing ataxic hemiparesis from other stroke syndromes is crucial for proper diagnosis and management.
- Clinical Examination: Careful assessment of motor strength, coordination, and gait is essential.
- Neuroimaging: MRI or CT scans of the brain are necessary to identify the location and extent of the lesion.
Treatment
Treatment focuses on rehabilitation and managing underlying risk factors for stroke.
- Physical Therapy: To improve strength, coordination, and balance.
- Occupational Therapy: To enhance activities of daily living.
- Speech Therapy: If dysarthria is present.
- Medical Management: Controlling blood pressure, cholesterol, and other risk factors to prevent future strokes.
