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The right thalamic ventral posterolateral nucleus seems to be determinant for macrosomatognosia: a case report

  • ElTarhouni, Amir H. Division of Neurorehabilitation, Fribourg Hospital, Meyriez, Switzerland
  • Beer, Laura Division of Neurorehabilitation, Fribourg Hospital, Meyriez, Switzerland
  • Mouthon, Michaël Neurology Unit, Department of Neuroscience and Movement Science, Medicine Section, Faculty of Science and Medicine, University of Fribourg, Chemin du Musée, 5, CH-1700 Fribourg, Switzerland
  • Erni, Britt Division of Neurorehabilitation, Fribourg Hospital, Meyriez, Switzerland
  • Aellen, Jerome Department of Radiology, Fribourg Hospital, Riaz, Switzerland
  • Annoni, Jean-Marie Neurology Unit, Department of Neuroscience and Movement Science, Medicine Section, Faculty of Science and Medicine, University of Fribourg, Chemin du Musée, 5, CH-1700 Fribourg, Switzerland
  • Accolla, Ettore A. Neurology Unit, Department of Neuroscience and Movement Science, Medicine Section, Faculty of Science and Medicine, University of Fribourg, Chemin du Musée, 5, CH-1700 Fribourg, Switzerland
  • Dieguez, Sebastian Neurology Unit, Department of Neuroscience and Movement Science, Medicine Section, Faculty of Science and Medicine, University of Fribourg, Chemin du Musée, 5, CH-1700 Fribourg, Switzerland
  • Chabwine, Joelle N. Division of Neurorehabilitation, Fribourg Hospital, Meyriez, Switzerland - Neurology Unit, Department of Neuroscience and Movement Science, Medicine Section, Faculty of Science and Medicine, University of Fribourg, Chemin du Musée, 5, CH-1700 Fribourg, Switzerland
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    28.10.2020
Published in:
  • BMC Neurology. - 2020, vol. 20, no. 1, p. 393
English Background: Macrosomatognosiais the illusory sensation of a substantially enlarged body part. This disorder of the body schema, also called “Alice in wonderland syndrome” is still poorly understood and requires careful documentation and analysis of cases. The patient presented here is unique owing to his unusual macrosomatognosia phenomenology, but also given the unreported localization of his most significant lesion in the right thalamus that allowed consistent anatomo-clinical analysis.Case presentation: This 45-years old man presented mainly with long-lasting and quasi-delusional macrosomatognosia associated to sensory deficits, both involving the left upper-body, in the context of a right thalamic ischemic lesion most presumably located in the ventral posterolateral nucleus. Fine-grained probabilistic and deterministic tractography revealed the most eloquent targets of the lesion projections to be the ipsilateral precuneus, superior parietal lobule,but also the right primary somatosensory cortex and, to a lesser extent, the right primary motor cortex. Under stationary neurorehabilitation, the patient slowly improved his symptoms and could be discharged back home and, later on, partially return to work.Conclusion: We discuss deficient neural processing and integration of sensory inputs within the right ventral posterolateral nucleus lesion as possible mechanisms underlying macrosomatognosia in light of observed anatomo-clinical correlations. On the other hand, difficulty to classify this unique constellation of Alice in wonderland syndrome calls for an alternative taxonomy of cognitive and psychic aspects of illusory body-size perceptions.
Faculty
Faculté des sciences et de médecine
Department
Médecine 3ème année, Département de Médecine
Language
  • English
Classification
Biology
License
License undefined
Identifiers
Persistent URL
https://folia.unifr.ch/unifr/documents/309016
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