[Dorsolateral thalamic infarct syndrome with therapeutically modifiable pain crises]

The Controlateral Pain Flexor Reflex (CPFR) is demonstrated by a case study of a thalamic syndrome with a typical thalamic hand, thalamic foot, and thalamic pain crisis. Mechanical triggering by a painful irritation on the healthy hand side leads to a stronger motoric-nocifensic reflex response of the contralateral extremities. On the other hand the healthy person would develop an ipsilateral nocifensic response only. In the case reported here, the electrically evoked CPFR led to the same result, and simultaneously caused disappearance of the thalamic pain, since this kind of management represents therapeutical approach via the endorphin system. In respect of the pathophysiological basis of the thalamic modified nocifensic reflex response, we are inclined to believe that painful stimulation evokes an accentuated flexor reaction if the thalamic-controlled influences are omitted by a lesion of the specific nuclei.