Body Lateropulsion With Involvement of the Medial Lemniscus Due to a Caudal Pontine Infarction

Abstract

A 63-year-old man with essential hypertension abruptly developed rightward body lateropulsion (BL) and mild dysesthesia in the right upper extremity. No other neurological abnormalities were observed. Cranial magnetic resonance imaging demonstrated a small infarct lesion in the medial zone of the caudal pons on the left side. Under anti-platelet agent, the patient became asymptomatic within 7 days. BL is defined as irresistible falling to one side without motor weakness. Damage to the ascending graviceptive pathway (GP) may cause BL, and its precise location remains uncertain. The findings of neurological and magnetic resonance imaging in our patient suggest that GP from the vestibular nuclei to the interstitial nucleus of Cajal may cross the midline in the caudal pons, and may run in the vicinity of the medial lemniscus.