Wessel K, Vieregge P, Kessler C, Kömpf D
Department of Neurology, Medical University of Lübeck, Germany.
Acta Neurol Scand. 1994 Sep;90(3):167-73. doi: 10.1111/j.1600-0404.1994.tb02700.x.
We studied 18 patients with a single ischemic thalamic lesion, who had somatosensory disturbances and/or central pain in the opposite hemibody, by correlating their clinical symptoms, somatosensory evoked potentials (SEPs), and computed tomography (CT) findings. Patients were divided into three groups: (1) those with somatosensory deficits, central pain, and abnormal SEPs, which comprised two thirds of the patients (classic thalamic pain syndrome), (2) those with somatosensory deficits, no central pain, and abnormal SEPs (analgetic thalamic syndrome), and (3) those with almost normal sense perception, central pain, and normal SEPs (pure algetic thalamic syndrome). CT evidence of a paramedian or anterolateral thalamic lesion might be an indicator for the development of central pain, because these types of infarctions occurred only in patients with the classic thalamic syndrome or the pure algetic thalamic syndrome. The differentiation of the thalamic syndrome into three subtypes is of prognostic value, because patients with a loss of cortical SEPs and a posterolateral ischemic thalamic lesion on the CT scan probably will not exhibit central pain.
我们通过关联18例患有单一缺血性丘脑病变且对侧半身存在躯体感觉障碍和/或中枢性疼痛患者的临床症状、躯体感觉诱发电位（SEP）及计算机断层扫描（CT）结果进行了研究。患者被分为三组：（1）有躯体感觉缺陷、中枢性疼痛及SEP异常的患者，占患者总数的三分之二（典型丘脑痛综合征）；（2）有躯体感觉缺陷、无中枢性疼痛及SEP异常的患者（镇痛性丘脑综合征）；（3）感觉知觉几乎正常、有中枢性疼痛及SEP正常的患者（纯痛觉性丘脑综合征）。丘脑旁正中或前外侧病变的CT证据可能是中枢性疼痛发生的一个指标，因为这些类型的梗死仅发生在典型丘脑综合征或纯痛觉性丘脑综合征患者中。将丘脑综合征分为三个亚型具有预后价值，因为CT扫描显示皮质SEP缺失且有丘脑后外侧缺血性病变的患者可能不会出现中枢性疼痛。
