[Ataxic hemiparesis with cerebellar dysarthria due to an opercular lesion]

A 63 year-old-man, with an opercular infarct had a motor deficit with ataxic hemiparesis and cerebellar dysarthria. The motor deficit disappeared, but the cerebellar signs remained after three months. A voice instrumental analysis confirmed the cerebellar pattern of the dysarthria. CT and MRI showed the opercular lesion and the normality of the cerebellum and the pons. A volumic MRI analysis precised the localisation and the volume of the lesion. The oxygen consumption (CMRO2) was measured with PET and showed no cerebellar diaschisis. We propose that, in this case, the cerebellar dysarthria is the orofacial ataxic component of the hemiparesis. We suggest that it is related to disruption of the cortico-cerebellar tract, connecting the right orofacial frontal area of the primary motor cortex with the paravermal segment of the left cerebellar hemisphere.