Published in:
01-06-2020 | Positron Emission Tomography | Neuro-Images
Limb ataxia after double hit in the Guillain–Mollaret triangle
Published in: Acta Neurologica Belgica | Issue 3/2020
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A 55-year-old woman presented with motor difficulties in the right arm and leg. She had a history of occipital headache and migraine; MRI of the brain 12 years earlier demonstrated an asymptomatic cavernous malformation in the tegmentum pontis, close to the left superior cerebellar peduncle (SCP) (Fig. 1a). She had marked difficulties with gait and handwriting. On clinical examination, irregular step length and decreased synkinesis were observed. The finger-to-nose test and finger tracking were atactic. She had right-sided limb ataxia, dysmetria and dysarthria.
Fig. 1
Coronal T2-weighted (a), axial susceptibility weighted (b), diffusion-weighted (c) and axial T2-weighted (d) brain MRI. 18F-fluoro-deoxy-d-glucose positron emission tomography (e). The cavernous malformation in the left tegmentum pontis is seen (a) and the contralateral atrophy of the dentate nucleus (b, arrow and c). The left-sided hypertrophic olivary degeneration is demonstrated (d, arrow). 18F-fluoro-deoxy-d-glucose positron emission tomography shows right cerebellar hypometabolism (e)
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