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April 1968

Sympathetic Deficits Following Thalamotomy

Author Affiliations

New York
From the Department of Neurological Surgery, College of Physicians and Surgeons, Columbia University, and the Neurosurgical Service, Columbia-Presbyterian Medical Center, Neurological Institute of New York.

Arch Neurol. 1968;18(4):378-387. doi:10.1001/archneur.1968.00470340064006

SYMPATHETIC deficits have been found in 15 patients who have undergone thalamotomy for dyskinesia. These deficits have consisted of ptosis, miosis, and hemianhydrosis on the side of the body ipsilateral to the lesion.

Sympathetic defects associated with brainstem lesions are not uncommon in clinical experience, as in the Wallenberg syndrome seen with lesions of the lateral medullary region. Apparently the efferent sympathetic pathways course through the lateral area of the medulla as they descend. However, reports of sympathetic loss with lesions rostral to the pons are rare. Small lesions of the upper brainstem which can be accurately localized and which result in limited defect are uncommon indeed. The investigation of these patients provides new information concerning the location of sympathetic paths at mesencephalic-diencephalic levels in man.

Materials and Methods  All of the patients reported in this series were operated on at the Neurological Institute of New York between May

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