title: Convulsive movements in bilateral paramedian thalamic and midbrain infarction.
abstract: Although some previous reports have described convulsive movements in bilateral paramedian thalamic and midbrain infarction, little is known about their nature. A 71-year-old man presented with impaired consciousness and clonic movements of both arms. Each series of movements lasted 10 to 20 s and occurred at 2-to 3-min intervals, which disappeared after intravenous administration of diazepam and phenytoin. Magnetic resonance imaging showed acute bilateral paramedian thalamic and midbrain infarction. A review of the literature revealed that convulsive movements were observed mostly at the onset of infarction. Clonic movements appeared frequently in the limbs, particularly in both arms. Clinical observations and results of animal experiments suggest that these seizures might originate from the mesencephalic reticular formation. Physicians should recognize this condition, because not only seizure control but also early management of ischemic stroke is required.
authors.affiliation: Department of Neurology, Juntendo University Shizuoka Hospital, Shizuoka, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Yamashiro
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Furuya
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Noda
authors.forename: Takao
authors.initials: T
authors.lastname: Urabe
authors.forename: Nobutaka
authors.initials: N
authors.lastname: Hattori
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Okuma