Fluctuating locked-in syndrome as a presentation of a bilateral pontine infarction

Neuroradiol J. 2016 Oct;29(5):347-9. doi: 10.1177/1971400916658896. Epub 2016 Jul 6.

Abstract

The "pontine warning syndrome" is characterized by recurrent episodes of motor hemiparesis, dysarthria and horizontal gaze palsy associated with basilar artery branch infarction. We report a case of a patient who presented with recurrent, self-limited episodes of locked-in syndrome, related to a bilateral pontine infarction. As far as we know, this clinical presentation as a subtype of pontine warning syndrome has never been described. We discuss the case, the differential diagnosis of the neuroimaging and the possible underlying mechanism.

Keywords: Stroke; capsular warning syndrome; locked-in; pontine warning syndrome.

Publication types

  • Case Reports

MeSH terms

  • Brain Infarction / pathology*
  • Brain Infarction / physiopathology*
  • Brain Infarction / therapy
  • Humans
  • Male
  • Middle Aged
  • Neuroimaging
  • Ocular Motility Disorders / complications*
  • Ocular Motility Disorders / diagnostic imaging
  • Paresis / etiology*
  • Pons / diagnostic imaging
  • Pons / pathology*
  • Tissue Plasminogen Activator / therapeutic use

Substances

  • Tissue Plasminogen Activator