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. 2020 Apr 6;20(1):120.
doi: 10.1186/s12883-020-01698-0.

Uncrossed corticospinal tracts in a patient with ichthyosis and hemiparesis: a case report

Huijia Yang  1 , Hongwei Zhou  2 , Jing Miao  3
Affiliations

Uncrossed corticospinal tracts in a patient with ichthyosis and hemiparesis: a case report

Huijia Yang et al. BMC Neurol. .

Abstract

Background: Anomalies of pyramidal tract decussation are rare phenomena that can be caused by ectodermal dysplasia. Herein, we describe a patient with ichthyosis who exhibited ipsilateral hemiparesis after stroke and whose neuroimaging results showed evidence of motor control being provided by the ipsilateral motor cortex.

Case presentation: A 24-year-old right-handed man presented with skin abnormalities, sudden-onset left hemiparesis, and dysarthria. He exhibited a mild-to-moderate left-sided weakness (grade 4 on the Medical Research Council scale). Magnetic resonance imaging revealed an acute infarct in the left corona radiata. Diffusion tensor imaging revealed uncrossed corticospinal tracts. Next-generation sequencing identified heterozygous FLG mutations. The patient was diagnosed with cerebral infarction and ichthyosis vulgaris and was treated with aspirin (100 mg/d). His symptoms gradually dissipated.

Conclusions: This case suggests that pyramidal decussation anomalies can be associated with ichthyosis. Patients with ichthyosis should therefore be evaluated for nerve involvement.

Keywords: DTI; Ihthyosis; Ipsilateral hemiparesis; Ischemic stroke; Uncrossed corticospinal tracts.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The skin on the patient’s shins was dry and scaly
Fig. 2
Fig. 2
a. Diffusion-weighted imaging revealed lesions with strong signal intensities and decreased apparent diffusion coefficients. b. Diffusion tensor imaging tractography revealed uncrossed corticospinal tracts. The red arrow shows the infarcted area in which the corticospinal tract was destroyed
See this image and copyright information in PMC

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