2009年2月5日 星期四

Dysarthria clumsy hand syndrome in a patient with ankylosing spondylitis

On Feb 4, 2009, a 50-year-old man who already had ankylosing spondylitis, diabetes mellitus, hypertension, hyperlipidemia, obstructive sleep apnea syndrome and gout came to my OPD because he had suffered from dysarthria and clumsy right hand for 2 weeks. He appeared central obesity, and laboratory revealed leukocytosis (WBC count=16,000 /uL). Brain MRI disclosed a paramedian pontine infarct. There was no stenosis in major intracranial arteries (shown by MRA).

Question 1: which side of pons was infarcted to cause his symptom?
Question 2: what is the relationship between his stroke and those above-mentioned medical problems? Do you believe ankylosing spondylitis is the culprit of his pontine infarct?
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