The dorsal spinocerebellar tract (DSCT) conveys unconscious proprioceptive information; however, gait ataxia associated with DSCT dysfunction is clinically uncommon and remains difficult to evaluate using standard neurological examinations. We report the case of a 68-year-old man with thoracic epidural diffuse large B-cell lymphoma causing spinal cord compression at the seventh to eighth thoracic vertebral levels. Following surgical decompression and systemic chemotherapy, muscle strength and conventional conscious proprioceptive findings improved; however, lower-extremity dysmetria and gait ataxia persisted over a 24-month follow-up period. The persistent gait disturbance and positive Romberg sign were compatible with possible DSCT dysfunction, although the evidence was indirect, and subtle posterior column dysfunction or residual myelopathy could not be fully excluded. This case highlights the importance of considering possible DSCT dysfunction in patients presenting with chronic gait ataxia despite apparently normal conventional sensory findings and underscores the value of careful longitudinal assessment for prognosis and rehabilitation planning.
Fukata et al. (Mon,) studied this question.