A case of pseudo-thalamic Syndrome resulting from a pontine tegmentum hemorrhage

The thalamic syndrome (Dejerine-Roussy Syndrome) resulting from the thalamic disorder is now understood as a syndrome characterized by hemiplegia, disturbance of sensation, hemiataxia, thalamic pain and choreoathetoid movement. Symptoms and signs resembling this syndrome, i. e. pseudo-thalamic syndrome, were reported in conjunction with some parietal lobe lesions. A case of pseudo-thalamic syndrome resulting from pontine hemorrhage is reported with a clinico-anatomical correlation study. The patient, a 56-year-old man, had suddenly developed right-hand numbness. Neurological examination on admission revealed Bruns-like nystagmus, slight disturbance of speech, right-sided hemiplegia, superficial and deep sensory deficiency and ataxia. A computed tomography taken 3 days after the beginning of the episode showed contrast enhancement around the bilateral pontine tegmentum (left dominant), but no abnormalities in the thalamus or the parietal lobe region. We discussed the topographical lesion of the symptoms and signs of the pseudo-thalamic syndrome seen in pontine tegmentum hemorrhage. We concluded that a pseudo-thalamic syndrome resulting from pontine lesions will be characterized by the presence of nystagmus.