Resumen

The Claude’s syndrome is a ventromedial midbrain syndrome characterized by ipsilateral oculomotor nerve palsy and contralateral cerebellar ataxia. There have been reported 32 cases since the original description in a patient with a midbrain infarction. The etiologies of this syndrome have been reported as infarctions, metastasis, and infections in this region. To our knowledge, this is the first case reported in the literature demonstrating bilateral Claude’s syndrome caused by a brain stem Glioma. Abbreviation key: MRI = Magnetic Resonance Imaging, NCCT = non-contrast computed tomography, OR = operation room, WHO = World Health Organization, RN = Red Nucleus, SCP = Superior Cerebellar Peduncle. Case Report: A 33-year-old woman was admitted to the emergency department with a three-month weight loss (22 pounds) associated to asthenia and general discomfort. O ne month before admission the patient presented gait instability and dysarthria with exaggerated accents. On examination the following vital signs were recorded: (1) blood pressure of 110/76 mm Hg, (2) pulse of 79 beats per minute, (3) respiratory rate of 14 breaths per minute, and (4) oxygen saturation of 97%. Multiple cafèau-lait spots greater than 5mm of diameter were observed in her thorax, abdomen, and limbs. Both pupils were 3 mm in diameter (constricting to 1 mm to light). She had left exotropia in the primary gaze (Figure 1). There was an incomplete limitation to elevate, descend, and adduce both eyes. There was observed also an incomplete limitation to intort each globe and an induced down gaze diplopia. No other cranial nerve palsy was noted. A symmetric spasticity was observed, with a patellar and aquilian hyperreflexia, and bilateral extensor plantar response as well. Deep (vibration and proprioception) and superficial sensibility was preserved. The patient had ataxic-spastic gait instability associated to ataxic dysarthria (scandid voice). No meningeal signs were observed and the rest of the evaluation was unremarkable.

Palabras clave: Claude’s syndrome ventromedial mesencephalon brain stem glioma.

2013-04-12   |   1,322 visitas   |   Evalua este artículo 0 valoraciones

Vol. 19 Núm.4. Octubre-Noviembre 2012 Pags. 379-381 Neurocien Colom 2012; 19(4)