Bilateral Paramedian Thalamic Syndrome After Infection

Kamasak T., ŞAHİN S., EYÜBOĞLU İ., REİS G. P., Cansu A.

PEDIATRIC NEUROLOGY, vol.52, no.2, pp.235-238, 2015 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 52 Issue: 2
  • Publication Date: 2015
  • Doi Number: 10.1016/j.pediatrneurol.2014.09.012
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.235-238
  • Karadeniz Technical University Affiliated: Yes


BACKGROUND: Although bilateral paramedian thalamic infarctions occur more frequently in adults than in children, they are rare entities at any age. The syndrome is thought to result from occlusion of the artery of Percheron, which arises as a common trunk from one of the posterior cerebral arteries to supply both paramedian thalamic regions. We describe two children with acute ischemic infarction involving both paramedian thalami developing after infection. PATIENTS: The first patient developed mutism with ataxia after chicken pox infection. The second child developed headache, somnolence, agitation, and speech dysfunction following an upper respiratory tract infection. Bilateral thalamic lesions were documented on magnetic resonance imaging of both children. CONCLUSION: Bilateral infarctions of the pararnedian thalamus may result in severe illness and impairment. Common clinical manifestations include disorientation, confusion, hypersomnolence, deep coma and "coma vigil," or akinetic mutism (awake unresponsiveness), as well as severe memory impairment.