Ann Rehabil Med.  2015 Dec;39(6):1033-1037. 10.5535/arm.2015.39.6.1033.

Abnormal Ocular Movement With Executive Dysfunction and Personality Change in Subject With Thalamic Infarction: A Case Report

• Kim EJ
• Kim MO
• Kim CH
• Joa KL
• Jung HY

• KMID: 2165632
• DOI: http://doi.org/10.5535/arm.2015.39.6.1033

Abstract

The thalamus, located between the cerebrum and midbrain, is a nuclear complex connected to the cerebral cortex that influences motor skills, cognition, and mood. The thalamus is composed of 50-60 nuclei and can be divided into four areas according to vascular supply. In addition, it can be divided into five areas according to function. Many studies have reported on a thalamic infarction causing motor or sensory changes, but few have reported on behavioral and executive aspects of the ophthalmoplegia of the thalamus. This study reports a rare case of a paramedian thalamus infarction affecting the dorsomedial area of the thalamus, manifesting as oculomotor nerve palsy, an abnormal behavioral change, and executive dysfunction. This special case is presented with a review of the anatomical basis and function of the thalamus.

Keyword

Thalamus; Ophthalmoplegia; Executive function; Behavior

MeSH Terms

Cerebral Cortex
Cerebrum
Cognition
Executive Function
Infarction*
Mesencephalon
Motor Skills
Oculomotor Nerve Diseases
Ophthalmoplegia
Thalamus

Figure

• 

  Fig. 1 A magnetic resonance image showing an acute right paramedian thalamic infarction and mild ischemic change possibly due to small vessel disease (A-H). Arrows point to the areas of the paramedian infarction on a diffuse weighted image (A-C) and on an apparent diffusion coefficient image (F, G).

• 

  Fig. 2 A computed tomography angiography reveals right posterior cerebral artery (PCA) stenosis. The right PCA stenosis possibly involves the P1 segment (arrow).

• 

  Fig. 3 The patient shows a lateral deviation of the right eye with forward gaze.

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