2002 issue 3

Back

Volume 11, issue 3

Case report

Bilateral thalamic infarction as a reason for persistent apathy and ocular movement disturbances – report on two cases

Małgorzata Wiszniewska1, ANDRZEJ CHMIELECKI2, IWONA MACIEJEWSKA-PIWAR2
1. Oddział Neurologii Szpitala Specjalistycznego w Pile
2. Zakład Radiologii Szpitala Specjalistycznego w Pile
Postępy Psychiatrii i Neurologii, 2002, 11, 301-305
Keywords: brain stroke, bilateral thalamic infarction, case report
Abstract

Isolated bilateral thalamic infarction is a rare type of cerebral ischaemic stroke. The predominant symptoms in infarction involving the nucleus medialis thalami bilaterally are: prominent loss of psychic self-activation, apathy, hypersomnia. There may also be disturbance of the eye movements without evidence of midbrain involvement on the CT. The authors observed two patients with ischaemic strokes in both paramedian thalamic regions. The initial stale of the stroke was serious in both patients (they demonstrated cerebral coma). Within a few days of recovering consciousness these patients were apathetic with hypersomnia without psychic self-activation. They presented depression and symptoms including vertical gaze palsies which are typical of the midbrain syndrome. Despite pharmacotherapy and rehabilitation the apathy and the disturbances of eye movement did not improve after half a year.

Address for correspondence:
Adres: Dr Krzysztof Nadgrodkiewicz,
Oddział Neurologii Wojewódzkiego Szpitala Specjalistycznego,
ul. Aleksandrowicza 5, 26-617 Radom