Body lateropulsion with hypalgesia and thermohypoesthesia in the territory of all divisions of the trigeminal nerve caused by a pontine infarction

Abstract

An 84-year-old woman with essential hypertension abruptly developed leftward body lateropulsion, hypalgesia and thermohypoesthesia in all divisions of the left trigeminal nerve, and concomitant skew deviation. Diffusion-weighted cranial magnetic resonance imaging demonstrated a small infarction in the right rostral pontine tegmentum. Although the ascending graviceptive pathway (GP) from the vestibular nuclei to the Cajal interstitial nucleus crosses the midline in the caudal pons, its precise location remains uncertain. In our patient, GP and the ventral trigeminothalamic tract might be simultaneously involved. Consequently, in the rostral pons, we speculated that GP might run in the vicinity of the ventral trigeminothalamic tract.