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Differentiation of Four Subtypes Assisted by Somatosensory Evoked Potentials Data

François Mauguière, MD; John E. Desmedt, MD

Arch Neurol. 1988;45(12):1312-1320.

Abstract
• In 30 patients with a thalamic vascular lesion and clinical somatosensory disturbances in the opposite hemibody without hemiplegia, four nosological groups were identified: group 1 had no central pain but complete hemianesthesia and loss of cortical somatosensory evoked potentials (SEPs) on the affected side (analgic thalamic syndrome). Group 2 had central pain, severe hypoesthesia, and loss of cortical SEPs. Group 3 had central pain and hypoesthesia, with cortical SEPs present, although reduced or delayed on the affected side. Group 4 had central pain with preserved touch and joint sensations and normal SEPs (pure algetic thalamic syndrome). Clinical signs and SEP titration of the actual involvement of lemniscal pathways in these four groups of patients with thalamic syndrome are discussed in relation to current pathophysiology of central pain.

Author Affiliations
From the Department of EEG and Epileptology, Faculty of Medicine Lyon-Nord, Hôpital Neurologique, Lyons, France (Dr Mauguière); and the Brain Research Unit, University of Brussels (Dr Desmedt).

Footnotes
Accepted for publication July 7, 1988.

Reprint requests to Brain Research Unit, 115 Boulevard de Waterloo, Brussels 1000, Belgium (Dr Desmedt).

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