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Neurol Sci (2013) 34:253254 DOI 10.1007/s10072-012-0992-2
LETTER TO THE EDITOR
Thumb, forenger, and lip numbness: a distinctive thalamic lacunar syndrome
Jos Berciano Enrique Marco de Lucas
Onofre Combarros
Received: 5 January 2012 / Accepted: 17 February 2012 / Published online: 25 February 2012 Springer-Verlag 2012
Sir,
The thalamus is the second most frequent location, after the pons, for lacunes and penetrating branch territory infarcts [1]. Pure sensory stroke occurs with occlusion of thalamogeniculate arteries involving the thalamic somatosensory nucleus [14]. Sensory abnormalities after minor thalamic stroke may be restricted to the acral part of the body, often presenting as a pattern of cheiro-oral syndrome [4]. In 1991, we described the case of a patient with a thalamic lacunar infarction, presumably involving the nucleus ventralis posterior (VP), causing contralateral restricted sensory disturbance of unique distribution, including intraoral and perioral regions, lips, thumb, and forenger [5]. Here, we report on another patient with similar semiology.
In February 2011, a 62-year-old woman suddenly noticed numbness and tightness in the lips, thumb, and forenger on the left side. For several years she had suffered from arterial hypertension incompletely controlled with several antihypertensive drugs recommended by her family doctor; no other risk factors of lacunar stroke, such as cigarette smoking or hypercholesterolemia, were noted [6]. Transient tightness of ipsilateral oral cavity was noticed. Two days after,...