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Isolated pseudoabducens palsy in acute thalamic stroke.
Mehdi Ghasemi1, Nazish Riaz1, Anna Bjornsdottir1
1Department of Neurology, University of Massachusetts Medical School, Worcester, MA 01655, USA.
Clinical Imaging
|February 8, 2017
Summary
Thalamic strokes can cause rare oculomotor issues like pseudoabducens palsy. This case highlights rapid recovery from esotropia following a left thalamic infarction.
Area of Science:
- Neuroscience
- Ophthalmology
- Neurology
Background:
- Oculomotor abnormalities are infrequently associated with thalamic strokes.
- Thalamic lesions can impact complex neural pathways controlling eye movements.
Observation:
- A young patient presented with isolated right pseudoabducens palsy and horizontal diplopia.
- Acute left thalamic infarction was confirmed via diffusion-weighted magnetic resonance imaging.
Findings:
- The patient's oculomotor palsy and esotropia resolved spontaneously within three days.
- This suggests a specific pathway interruption within the paramedian thalamus affecting convergence.
Implications:
- The findings support the role of the paramedian thalamus in regulating inhibitory convergence pathways.
- Understanding these pathways is crucial for diagnosing and managing specific types of esotropia and oculomotor palsies.
