Dysarthria/clumsy hand
Although now considered to be a variant of ataxic hemiparesis, this disorder is usually still classified as a separate lacunar syndrome. The lesion is in the pons.
The main symptoms are dysarthria and clumsiness (ie, weakness) of the hand, which are often most prominent when the patient is writing.
Unilateral lower facial weakness with dysarthric speech is noted. On protrusion, the tongue may deviate to the side of facial weakness. A mild, ipsilateral hemiparesis is usually noted, but the arm is ataxic. Ipsilateral hyperreflexia and Babinski sign may be observed.