Thalamic syndrome: symptoms and treatments

Of all the brain structures, the thalamus is one of the best known, due to the number of functions it has and the importance of each of them. Furthermore, the thalamus is a crossroads point for neuronal pathways.

An injury to this structure can lead to a thalamic syndrome, a clinical picture of low frequency of occurrence and that appears mainly in elderly people. Below, we explain what it is and the consequences it entails.

Symptoms of thalamic syndrome

Thalamic syndrome or Déjerine-Roussy syndrome was first described in 1903. It is characterized, as studies say, by presenting different signs and symptoms such as sensations of tingling and numbness in parts of the body, loss of tactile sensation or hypersensitivity to environmental stimuli, total or partial paralysis and involuntary movements.

Thus, the most commonly noticeable symptoms and signs of thalamic syndrome are the following:

Intense and persistent pain in the extremities.Stimuli such as emotional stress, superficial touch, or cold or warm temperatures can trigger exacerbated painful sensations.The reaction to pain is usually exaggerated, even in the face of stimuli that in themselves generate little sensation of physical damage. Weakness or paralysis in the affected limbs.Abnormal involuntary movements.Loss of position sense, characterized above all by difficulty in locating the specific position of a limb.

One of the most common causes of this syndrome is the disruption of blood flow. which provides the nutrients necessary to keep your cells alive. This lack of irrigation can occur due to blockage or rupture of a vessel that nourishes the thalamus or because another different expansive process has cut off the flow, due to pressure, of one of the vessels responsible for supplying it with blood.

Nevertheless, There are lesions of the thalamus of another nature, such as those of metabolic or neoplastic origin, which also causes thalamic syndrome.

On the other hand, some factors may predispose to suffering a stroke and increase the chances of suffering from this syndrome, such as the following:

Cardiac arrhythmias.Arterial hypertension.Elevated ‘bad’ cholesterol levels.Sedentary lifestyle.Genetic predisposition.

In most cases, the diagnosis of thalamic syndrome is reached through a exclusion diagnosis process. Those people who have suffered a cerebrovascular event and suffer from pain or abnormal sensations undergo an exhaustive process of eliminating possible sources of pain.

It is in this way that, if no other explanation is finally found for the presence of pain, a thalamic syndrome can be diagnosed more accurately. However, This diagnosis must be supported by neuroimaging studies.

Treatment

The first line of treatment, once the person’s survival is assured, is symptomatic. It is aimed at addressing the secondary symptoms of this pathology. These symptoms, for the most part, are related to sensory and motor alterations.

Regarding the pharmacotherapeutic approach, the medications most frequently usedas the literature indicates, are the following:

Opioids.Antidepressants.Anticonvulsants.Topical pain medications.

As for preventive measures, there are currently no truly effective techniques to prevent the appearance of thalamic syndrome. However, some can be adopted measures for the management of predisposing factors to this syndromewhich are generally related to lifestyle and general health.

In most cases, the main determining factor in the prognosis of this disease is the severity of the injury. In general, it is a neurological problem that, although it can be alleviated, does not completely resolve, so the usual thing is the need to adhere to lifelong pharmacological analgesic treatment.

Generally speaking, some of the most serious complications of thalamic syndrome are related to quality of life. Chronic pain usually remains a residual symptom along with hypersensitivity to touch and other external stimuli, which significantly reduces the vital comfort of the affected person.

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