Abnormal postural reflexes in a patient with pontine ischaemia

• Published in: BMJ case reports Vol. 2015; p. bcr2015210616
• Main Authors: Cantello, Roberto, Magistrelli, Luca, Terazzi, Emanuela, Grossini, Elena
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 11.11.2015; BMJ Publishing Group
• Series: Case Report
• Subjects: 80 years; Aged, 80 and over; Decerebrate State - diagnosis; Decerebrate State - etiology; Decerebrate State - physiopathology; Europe (West); Female; Findings That Shed New Light on the Possible Pathogenesis of a Disease or an Adverse Effect; Humans; Ischemia; Medical imaging; Neck; Physiology; 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; White
• ISSN: 1757-790X; 1757-790X
• DOI: 10.1136/bcr-2015-210616

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.