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Abstract T P189: Pure Dysarthria and Dysarthria-facial Paresis Syndrome due to Internal Capsule and/or Corona Radiata Infarction


 Background and Purpose:
 Pure dysarthria (PD) and dysarthria-facial paresis syndrome (DFP) are considered as rare clinical entities of dysarthria-clumsy hand syndrome, mainly due to small vessel disease. We aimed to clarify the clinical and radiographic difference between patients with PD and DFP, especially due to internal capsule and/or corona radiata infarction, using the database of wide area network-based clinical research.
 
 
 Methods:
 This multicenter, prospective, observational study included consecutive patients with acute ischemic stroke admitted to 4 stroke centers in Fukuoka prefecture within 7 days from the onset. We included patients with first ever stroke and presenting PD or DFP with a single ischemic lesion localized in the internal capsule and/or corona radiata. Patients with any motor-sensory disturbance or cortical symptoms were excluded. Ischemic lesion volume was calculated by the A*B*C/2 method on diffusion weighted imaging. The local ethics committee approved the collection and submission of each patient’s clinical data to the study office in Kyushu University.
 
 
 Results:
 Between October 2010 and April 2014, a total of 2348 patients including 1773 (1006 men, 73.3±13.1 years) with first ever stroke were registered. Of them, 12 (0.68%) patients with PD and 18 (1.02%) patients with DFP were included for the analysis. Compared to patients with PD, patients with DFP had shorter onset-to-door time (median 10.75 [7.25-27.125] hours vs. 33.75 [14.25-51.5] hours, p = 0.042), larger vertical length (C component) of ischemic lesions (median 18.75 [12-20.625] mm vs. 9.25 [6-13] mm, p = 0.008), and greater ischemic lesion volume (median 828 [291-1664] mm3 vs. 289 [120-416] mm3, p = 0.031). Ischemic lesions causing PD were located more frequently in the left hemisphere than those of DFP (92% vs. 56%, p = 0.049). There was no difference in age, sex, and vascular risk factors between patients with PD and DFP. Symptom progression after admission was seen in one PD case which worsened to DFP.
 
 
 Conclusions:
 In cerebral infarction of the internal capsule and/or corona radiata, DFP might be derived from larger, vertically longer ischemic lesions comparing to PD. There might be stronger association between PD and left-sided lesions.
