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2006, Number 2

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Rev Neurol Neurocir Psiquiat 2006; 39 (2)

Treatment of Thalamic Syndrome (Dejerine-Roussy) secondary to isquemic cerebral infarction with Gabapentine. Report of four cases and literature review

Salazar-Zúñiga A, Carrasco-Vargas H

Language: Spanish
References: 22
Page: 70-75
PDF size: 189.83 Kb.


ABSTRACT

Introduction: We describe four clinical cases that attended external consultation of Neurology and/or entry into the Neurology and Neurosurgery Department of the Military Central Hospital of Mexico City. The four patients with isquemic cerebral infarction in the posterior region of the thalamus presented Thalamic Syndrome (Dejerine-Roussy), contralateral to the injury, characterized by: hemiparesia without contracture and quickly regressive; superficial persistent hemianesthesia; cutaneous hyperalgesia; disturbances of deep sensitivity; light hemiataxia and complete stereognosis; severe, persistent, paroxystic pain frequently intolerable, of the hemiparetic side, that did not yield with common analgesic. Without choreoathetoid movements of the paretic side; cutaneous-abdominal reflections and the plantar answers are normal. The four patients presented disappearance of the pain to 24 hs of initiate the treatment with gabapentine 400 mgs 1x3 O, and have continued asymptomatic, until the moment of this report. We make a bibliographical revision of literature in order to show the clinical manifestations, laboratory studies, neuroimage and the diverse treatments. Also, to mention the mechanisms of action of the antiepileptic and analgesic gabapentine in the thalamic syndrome.
Conclusions: The action mechanisms of gabapentine on the central neuropatic pain are through the union of the subunit α2 of voltage dependent calcium channels; increase in the GABA syntheses, and antagonism of the receptors non-NMDA. Also to show the good answer of our patients to gabapentine clearing the central neuropatic pain and suffering, that avoid to subject them to a procedure of stereotaxic neurosurgery.


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