Cheiro-oral Syndrome : A Clinicoradiological Review of 10 Patients

J Korean Neurol Assoc > Volume 15(4); 1997 > Article

Journal of the Korean Neurological Association 1997;15(4): 816-824.

수구증후군의 임상적 고찰

조수현, 황선출, 강영중, 김성환, 최문성, 문덕홍, 홍성욱

메리놀병원 신경과, 춘해병원 신경과

Cheiro-oral Syndrome : A Clinicoradiological Review of 10 Patients

Su Hyun Cho, M.D., Seon Chool Hwang, M.D., Young Jung Kang, M.D., Seong Hwan Kim, M.D., Mun Seong Choi, M.D., Deok Hong Moon, M.D., Seong Uk Hong, M.D.

Departments of Neurology, Marynoll General Hospital, and Choon Hae Hospital

Abstract

Background and Object : Cheiro-oral syndrome (COS) is characterized by a sensory disturbance in the unilateral hand and ipsilateral mouth corner. It is usually due to a lesion in the parietal cortex, thatamocortical projections, thalamus, or rarely brain stem. However, the syndrome is relatively unknown and rarely mentioned in most neurological textbooks. We presented ten cases of COS with a review of the clinical symptoms and signs and the neuroradiological methods used to demonstrate the responsible site. Methods and Results : We studied 10 patients with stroke who showed restricted sensory disturbance on the one hand and ispilateral mouth. The study forms consisted of clinical manifestaion, neurological examination, electrophysiological, and neuroradiologic studies. Computed tomography and/or magnetic resonance imaging identified lesion in the thalamus in 5, brain stem in 3, and corona radiata in 1 patient. But, the anatomical responsible site for one case was not founded. Infarction had occurred in nine cases and hemorrhage in one. Seven of the 10 patients showed sensory disturbances restricted to the perioral area, hands, fingers when they were first examined; the remaining patients complained more diffuse sensory disturbances at first, but it had become restricted to perioral and fingers, usually within 2-3 weeks. The durations of symptom varied from 5 days to more than 15 months and these symptoms were improved within 2-3 weeks to 4 months in treated patients. Conclusion : When the symptoms and signs of the COS were presented, especially if a history of migraine is lacking, neuroradiological methods such as CT or MRI should be undertaken to localize and diffentiate the nature of lesion.