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Thalamic infarct presenting with thalamic astasia.

P H Lee1, J H Lee, U S Joo

  • 1Department of Neurology, School of Medicine, Ajou University, Suwon, South Korea. phisland@chol.net

European Journal of Neurology
|April 5, 2005
PubMed
Summary

A rare case of astasia, the inability to stand, was observed in a patient with a right thalamic infarct. This finding suggests the thalamus plays a crucial role in maintaining upright posture and balance.

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Area of Science:

  • Neurology
  • Neuroscience
  • Neuroimaging

Background:

  • Astasia, characterized by the inability to stand unsupported despite adequate muscle strength, is often associated with balance impairment seen in vestibulocerebellar diseases.
  • The thalamus, a critical relay center in the brain, is known to be involved in motor control and sensory integration.

Observation:

  • A 76-year-old hypertensive woman presented with severe unsteadiness and inability to stand unsupported, exhibiting marked swaying and frequent collapses.
  • Neurological examination revealed no significant muscle weakness, highlighting a primary balance deficit.

Findings:

  • Diffusion-weighted magnetic resonance imaging (MRI) identified a discrete infarct in the right posterolateral thalamus.
  • Brain single-photon emission computed tomography (SPECT) showed reduced regional cerebral blood flow in the right thalamus and the left superior cerebellar region.

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Implications:

  • This case suggests that a unilateral thalamic infarct can cause astasia, challenging the traditional understanding of its etiology.
  • The findings indicate a potential role of the thalamus in the neural circuitry responsible for maintaining upright stance and balance.
  • Further research into thalamic astasia may reveal novel therapeutic targets for balance disorders.