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Case Report
4 (
2
); 220-223
doi:
10.4103/0976-3147.112775

Unilateral asterixis, thalamic astasia and vertical one and half syndrome in a unilateral posterior thalamo‑subthalamic paramedian infarct: An interesting case report

Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka
Department of Neurosciences, New Vikram Hospital, Madurai, Tamil Nadu, India
Address for correspondence: Dr. Subasree Ramakrishnan Department of Neurology, NIMHANS Bangalore, Karnataka India subasree.ramakrishnan@gmail.com
Licence
This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Disclaimer:
This article was originally published by Thieme Medical and Scientific Publishers Private Ltd. and was migrated to Scientific Scholar after the change of Publisher.

Abstract

ABSTRACT

A 42-year-old young lady presented with acute onset of dizziness, drooping of left eye with binocular diplopia and inability to walk unassisted. She had past history of uncontrolled diabetes mellitus and hypertension. On examination, she had left fascicular type of third nerve palsy, vertical one and half syndrome (VOHS), left internuclear ophthalmoplegia and skew deviation with ipsilesional hypertropia. She also had thalamic astasia and right unilateral asterixis. Her MRI revealed T2 and Flair hyper intense signal changes with restricted diffusion in the left thalamus, subthalamus and left midbrain. MR Angiography was normal. Thalamic‑subthalamic paramedian territory infarct is relatively uncommon. It can present with oculomotor abnormalities including vertical one and half syndrome, skew deviation, thalamic astasia and asterixis. This case is reported for the rarity of the presenting clinical findings in unilateral thalamo‑mesencephalic infarcts.

Keywords

Thalamic astasia
thalamo‑mesencephalic infarct
unilateral asterixis
vertical one and a half syndrome

Conflict of Interest

None declared

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