Thalamic infarct presenting as catastrophic life-threatening event in an older adult.
Aging Clin Exp Res
; 23(4): 320-2, 2011 Aug.
Article
in En
| MEDLINE
| ID: mdl-20885123
ABSTRACT
An 84 year old woman with history of moderate Alzheimer's disease, depression, and an anxiety disorder presented to our emergency room at Victoria Hospital, London, Ontario in an 'unresponsive' state. The patient was akinetic with mutism, and clonic perseveration induced in the upper limbs was evident while she was examined. Heart attack, massive stroke, or intracranial bleed were ruled out, and an electroencephalogram showed no epileptiform activity. Despite a normal CT, a magnetic resonance scan was ordered and showed bilateral acute paramedian thalamogeniculate infarction arising from occlusion of the artery of Percheron. Bilateral thalamic infarcts can cause sudden onset of akinetic mutism with clonic perseveration, which may be confused with coma and seizures due to life threatening conditions such as a massive stroke. Thorough clinical assessment and early use of MRI scanning will assist physicians with a more accurate diagnosis of older adults with this kind of presentation.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Thalamus
/
Cerebral Infarction
/
Akinetic Mutism
Limits:
Aged80
/
Female
/
Humans
Language:
En
Journal:
Aging Clin Exp Res
Journal subject:
GERIATRIA
Year:
2011
Document type:
Article
Affiliation country:
Canada