Painful ataxic hemiparesis
J. Bogousslavsky, F. Regli, J. Ghika and J. J. Feldmeyer
Right hemiparesis with right-sided pain and ataxia developed in a
68-year-old man. Sensation, neuropsychological function, and somatosensory
evoked potentials were normal. Computed tomography showed an isolated fresh
infarct in the left part of the thalamus. The pain and ataxic disturbances
were related to involvement of the thalamus itself, but the hemiparesis
with hyperactive tendon reflexes and Babinski's sign was probably due to
associated dysfunction in the adjacent internal capsule from compression or
edema. In the available clinicopathological reports of cases with
hemiparesis and thalamic infarction, contiguous involvement of the internal
capsule or no associated lesion has been reported. Because of the
occurrence of pain, which is not present in pontine, mesencephalic, or
capsular ataxic hemiparesis, we suggest that the syndrome seen in our
patient be called "painful ataxic hemiparesis."
