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Bilateral thalamic infarct as a diagnosed conversion disorder.

Ugur Lok¹, Oner Yalin, Ramazan Odes

¹Department of Emergency Medicine, Adiyaman University of Medical Faculty, Adiyaman, Turkey. ugurlok@hotmail.com

The American Journal of Emergency Medicine

|February 13, 2013

Summary

Bilateral thalamic infarcts, though rare, can cause severe consciousness impairment and cognitive issues. These strokes are often misdiagnosed in emergency departments, particularly in younger individuals.

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Area of Science:

Neurology
Neuroradiology

Background:

Bilateral thalamic infarcts are a rare cerebrovascular event.
These infarcts, particularly paramedian thalamic lesions, can result in significant neurological deficits.

Observation:

Patients may present with sudden lethargy or coma without motor deficits, mimicking subarachnoid hemorrhage.
Other presentations include behavioral changes, disorientation, memory loss, and thought disorders.

Findings:

Bilateral thalamic infarction is frequently overlooked in emergency departments, especially in younger patients.
Misdiagnosis is more common when advanced imaging like MRI is not performed, leading to potential psychiatric diagnoses.

Implications:

Consider bilateral thalamic infarct in emergency department patients presenting with new-onset conversion disorder.
Increased awareness and appropriate neuroimaging can improve diagnostic accuracy for this uncommon stroke type.