[Déjerine-Roussy syndrome of an ischaemic origin in an adolescent with patent foramen ovale].
BACKGROUND
Déjerine-Roussy syndrome, or thalamic syndrome, is characterised by transient mild hemiparesis, hemichoreoathetosis, hemihypoesthesia, hyperalgesia, allodynia and hemiataxia with astereognosia that varies in intensity, and it appears in the presence of lesions in the posterior nuclei of the thalamus. It can be produced by strategic cerebral infarction, reported in elderly patients with vascular risk factors. Patent foramen ovale has been suggested as a risk factor for ischaemic stroke in young people, especially when associated to aneurysm of the auricular septum and above all to a procoagulating status.


METHODS
An 18-year-old male with a family history of Behçet's disease, who presented right-side thalamic and hippocampal cerebral infarction; following an exhaustive study, patent foramen ovale with septal aneurysm was found as the only risk factor. At that time he did not satisfy criteria for Behçet's disease, and thorough systemic screening did not reveal direct or indirect signs of venous thrombosis. Percutaneous closure of the foramen was performed.


CONCLUSIONS
This is the first reported case of Déjerine-Roussy syndrome as a manifestation of cryptogenic cerebral infarction associated to patent foramen ovale in an adolescent. Taken as a whole, the clinical and complementary data enable us to reconstruct the pathophysiological sequence that position foramen ovale with an associated septal 'aneurysm' as the only detectable risk factor, which, when linked to the stress of the patient and the family, triggered its early closure.
de la Cruz-Cosme
C
C
Servicio de Neurología, Hospital Clinico Universitario Virgen de la Victoria, Campus de Teatinos, Málaga, España. drcruzcosme@hotmail.com
Márquez-Martínez
M
M
Hamad-Cueto
O
O
Rodríguez-Bailón
I
I
Heras-Pérez
J A
JA
Romero-Acebal
M
M
D000293:Adolescent; D001528:Behcet Syndrome / Q000473:pathology / Q000503:physiopathology; D002544:Cerebral Infarction / Q000209:etiology* / Q000473:pathology; D054092:Foramen Ovale, Patent / Q000150:complications*; D006624:Hippocampus / Q000473:pathology; D006801:Humans; D008297:Male; D012307:Risk Factors; D013786:Thalamic Diseases / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D013788:Thalamus / Q000473:pathology