Korean J Geriatr Gerontol.  2015 Dec;16(2):84-87. 10.15656/kjcg.2015.16.2.84.

Acute Pontine Infarction Presenting with Isolated Unilateral Masticatory Muscle Weakness

• Lee DS
• Ha YS
• Kim MK
• Yoo BG

• KMID: 2566519
• DOI: http://doi.org/10.15656/kjcg.2015.16.2.84

Abstract

Dorsolateral midpontine lesions can lead to ataxia of limbs, paralysis of muscles of mastication, impaired sensation over side of face. A few cases of masticatory muscle weakness due to pontine lesion have been reported. We report a patient with acute pontine infarction presenting with isolated unilateral masticatory muscle weakness without any other neurologic deficit. A 77-year-old woman complained sudden onset of chewing weakness on her left cheek. Neurological examination revealed decreased power of the left masseter muscle. There are no other neurologic abnormalities including facial sensation. Brain MRI showed multiple scattered infarction in the left ventrolateral and dorsolateral pons. She was treated with clopidogrel and atorvastatin. Trigeminal motor nucleus lies immediately medial to the principal sensory nucleus in the pontine tegmentum. Isolated trigeminal motor weakness can be caused by small pontine tegmental lesion.

Keyword

Brainstem infarction; Pons; Trigeminal motor nucleus; Mastication