Horizontal appendicular dysmetria in four patients with a typical Wallenberg's syndrome

During the acute stage of a Wallenberg's syndrome ipsilateral appendicular dysmetria is frequently seen. The dysmetria is more apparent in the ipsilat eral upper extremity. These patients also have a peculiar type of dysmetric eye movements that are characterized by hypermetric saccades toward the si de of the lesion and hypometric saccades to the opposite side. We examined four patients with acute Wallenberg's syndrome and found horizontal dysmetr ia of the affected extremity. Hypermetric arm and hand movements were prese nt to the side of the lesion and hypometric movements toward the opposite s ide. This type of dysmetria is probably related to the same patophysiologic al mechanism that underlies dysmetric eye movements in the Wallenberg's syn drome. The dysmetria tends to disappear with time although it continues to be present in some patients sir months after the ischemic damage.