Parietal pseudothalamic pain syndrome. Clinical features and anatomic correlates
J. D. Schmahmann and D. Leifer
Department of Neurology, Massachusetts General Hospital, Boston 02114.
We studied six patients who developed spontaneous hemibody pain following
lesions of the parietal lobe. The pain was characterized as burning or
icelike, and was associated with impairment of pin and temperature
appreciation. Computed tomographic scanning showed that the common area of
involvement in all cases was the white matter deep to both the caudal
insula and the opercular region of the posterior parietal cortex. We
suggest that disruption of the interconnections between these cerebral
cortical areas (including the second somatosensory representation, SII) and
the thalamus, particularly the intralaminar and ventroposterior nuclei, may
be responsible for producing a thalamocortical disconnection syndrome with
spontaneous pain as its clinical manifestation.
Patterns of sensory abnormality in cortical stroke: Evidence for a dichotomized sensory system
Kim
Neurology 2007;68:174-180.
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Laser-Evoked Potentials Are Graded and Somatotopically Organized Anteroposteriorly in the Operculoinsular Cortex of Anesthetized Monkeys
Baumgartner et al.
J. Neurophysiol. 2006;96:2802-2808.
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Anteroposterior somatotopy of innocuous cooling activation focus in human dorsal posterior insular cortex
Hua et al.
Am. J. Physiol. Regul. Integr. Comp. Physiol. 2005;289:R319-R325.
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Neurogenic Pain and Abnormal Movements Contralateral to an Anterior Parietal Artery Stroke
Rossetti et al.
Arch Neurol 2003;60:1004-1006.
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Representation of Pain and Somatic Sensation in the Human Insula: a Study of Responses to Direct Electrical Cortical Stimulation
Ostrowsky et al.
Cereb Cortex 2002;12:376-385.
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Cytoarchitectonic and immunohistochemical characterization of a specific pain and temperature relay, the posterior portion of the ventral medial nucleus, in the human thalamus
Blomqvist et al.
Brain 2000;123:601-619.
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Behavioral Thermosensitivity After Lesions of Thalamic Target Areas of a Thermosensory Spinothalamic Pathway in the Cat
Norrsell and Craig
J. Neurophysiol. 1999;82:611-625.
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Forebrain mechanisms of nociception and pain: Analysis through imaging
Casey
Proc. Natl. Acad. Sci. USA 1999;96:7668-7674.
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Differentiating Cortical Areas Related to Pain Perception From Stimulus Identification: Temporal Analysis of fMRI Activity
Apkarian et al.
J. Neurophysiol. 1999;81:2956-2963.
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Cerebral Processing of Acute Skin and Muscle Pain in Humans
Svensson et al.
J. Neurophysiol. 1997;78:450-460.
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