The dysarthria—clumsy hand syndrome: A distinct clinical entity related to pontine infarction

Abstract

Using magnetic resonance imaging, we studied 6 patients with the dysarthria–clumsy hand syndrome. All were found to have pontine infarctions contralateral to the symptomatic side. Clinically, these patients exhibited dysarthria; “clumsiness,” characterized by dysmetria, dysrhythmia, dysdiadochokinesia and sometimes truncal and gait ataxia; and mild ipsilateral weakness. Previous clinical‐anatomical correlations for this syndrome are limited by inconsistencies in clinical diagnostic criteria and low‐resolution imaging methods. In our patients, and in a review of the literature, the overwhelming majority of patients with the dysarthria–clumsy hand syndrome had pontine infarcts. We conclude that if rigid clinical criteria are used, the label of the dysarthria–clumsy hand syndrome predicts a lesion in the contralateral basis pontis.