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Dysarthria-Clumsy Hand – Lacunar Syndrome — SCE Neurology MCQ

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ModerateCerebrovascular DiseaseDysarthria-Clumsy Hand – Lacunar SyndromeSCE Neurology

A 60-year-old man with a left lacunar stroke presents with dysarthria and clumsiness of the right hand. He has no weakness, no sensory loss, and no visual field defect. MRI shows a small lacunar infarct in the left basis pontis. What lacunar syndrome does he have?

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Correct answer: C — Dysarthria-clumsy hand syndrome

Dysarthria-clumsy hand syndrome is a lacunar syndrome characterised by dysarthria, facial weakness, dysphagia, and clumsiness/weakness of the hand with no sensory loss or visual field defect. It most commonly results from lacunar infarcts in the basis pontis or genu of the internal capsule. A: Pure motor has proportional face/arm/leg weakness. C: Pure sensory has no motor/speech features. D: Ataxic hemiparesis has cerebellar-type ataxia. E: Sensorimotor has both weakness and sensory loss.

Reference: RCP Stroke Guidelines; Fisher Lacunar Syndromes