Abnormal postural reflexes in a patient with pontine ischaemia

BMJ Case Rep. 2015 Nov 11:2015:bcr2015210616. doi: 10.1136/bcr-2015-210616.

Abstract

The control of body posture is a complex activity that needs a very close relationship between different structures, such as the vestibular system, and the muscle and joint receptors of the neck. Damage of even one of these structures can lead to abnormal postural reflexes. We describe a case of a woman with a left pontine ischaemia who developed a 'dystonic' extensor posture of the left limbs while turned on the right side. This clinical picture differs from previous reports on the subject, and may relate to ischaemic damage of a pontine structure involved in posture control, or of adjacent neural connections to be yet identified. To the best of our knowledge, this is the first case reported in the literature. Clinical examples of an altered interplay between vestibular and neck receptors are rare.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged, 80 and over
  • Decerebrate State / diagnosis*
  • Decerebrate State / etiology
  • Decerebrate State / physiopathology
  • Female
  • Humans
  • Ischemia*
  • Neck
  • Pons / blood supply*
  • Pons / pathology
  • Posture
  • Reflex, Abnormal
  • Seizures / etiology
  • Seizures / pathology*
  • Sleep Stages
  • Tomography, X-Ray Computed
  • Vestibule, Labyrinth / blood supply*
  • Vestibule, Labyrinth / pathology