Ataxic hemiparesis: a narrative review for clinical practice in rehabilitation

ABSTRACT

Background

Ataxic hemiparesis (AH) is a well-recognized clinical lacunar stroke syndrome, characterized by paresis with ataxia on the same side of the body. It affects patients with stroke involving the basal ganglia, pons, internal capsule, corona radiata, and thalamus. In the past, lacunar syndrome denotes good functional recovery with low mortality and morbidity rate. However, recent evidence suggests AH has an association with more debilitating outcomes in the long term.

Objective

To provide a comprehensive narrative review of published literatures on the topics related with AH and update clinical practice including rehabilitation.

Methods

Literature review was performed by using the keywords “Subcortical Ataxia,” “Lacunar Stroke,” “Diaschisis”, and “Ataxic Hemiparesis” on PubMed and Google Scholar Engines from 1978 to 2022. All papers published in English were reviewed and manual search of references from retrieved literature was performed for other relevant articles.

Results

A comprehensive review was carried out on the following topics: neuroanatomical localization, pathogenesis, clinical features and clinical assessment scales, pharmacological and non-pharmacological modalities for ataxia treatment, prognosis, and outcome.

Conclusion

AH imposes significant challenges on stroke survivors when it comes to remediation of balance and coordination. It is associated with increased risk of mortality, stroke recurrence, and dementia. Though application of the concept of neuroplasticity and the utilization of repetitive transcranial magnetic stimulation have shown early promising results, further research is needed to establish the practice guidelines for rehabilitation of patients with AH.

KEYWORDS:

• Subcortical ataxia
• lacunar stroke
• diaschisis
• ataxic hemiparesis

Disclosure statement

The authors have no potential conflicts of interest to disclose.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/10749357.2023.2281722.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.