title: Bilateral paramedian thalamic syndrome after infection.
abstract: BACKGROUND
  Although bilateral paramedian thalamic infarctions occur more frequently in adults than in children, they are rare entities at any age. The syndrome is thought to result from occlusion of the artery of Percheron, which arises as a common trunk from one of the posterior cerebral arteries to supply both paramedian thalamic regions. We describe two children with acute ischemic infarction involving both paramedian thalami developing after infection.
  
  
  METHODS
  The first patient developed mutism with ataxia after chicken pox infection. The second child developed headache, somnolence, agitation, and speech dysfunction following an upper respiratory tract infection. Bilateral thalamic lesions were documented on magnetic resonance imaging of both children.
  
  
  CONCLUSIONS
  Bilateral infarctions of the paramedian thalamus may result in severe illness and impairment. Common clinical manifestations include disorientation, confusion, hypersomnolence, deep coma and "coma vigil," or akinetic mutism (awake unresponsiveness), as well as severe memory impairment.
authors.affiliation: Pediatric Neurology, Karadeniz Teknik University Pediatric Neurology, Trabzon, Turkey. Electronic address: tkamasak@hotmail.com.
authors.forename: Tülay
authors.initials: T
authors.lastname: Kamaşak
authors.affiliation: Pediatric Neurology, Teknik University, Trabzon, Turkey.
authors.forename: Sevim
authors.initials: S
authors.lastname: Sahin
authors.affiliation: Radiology Department, Karadeniz Teknik University, Trabzon, Turkey.
authors.forename: İlker
authors.initials: İ
authors.lastname: Eyüboğlu
authors.affiliation: Pediatric Hematology and Oncology, Karadeniz Teknik University, Trabzon, Turkey.
authors.forename: Gökce Pinar
authors.initials: GP
authors.lastname: Reis
authors.affiliation: Pediatric Neurology, Karadeniz Teknik University Pediatric Neurology, Trabzon, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Cansu
mesh_terms: D001259:Ataxia / Q000150:complications*; D002644:Chickenpox / Q000150:complications*; D002675:Child, Preschool; D056324:Diffusion Tensor Imaging; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009155:Mutism / Q000209:etiology; D013786:Thalamic Diseases / Q000175:diagnosis / Q000209:etiology / Q000821:virology
keywords: ataxia; bilateral paramedian posterior thalamic syndrome; mutism