Thalamic disequilibrium syndrome after thrombolytic therapy for acute myocardial infarction

Abstract

Thalamic disequilibrium syndrome (TDS) refers to unsteady stance and gait resulting from unilateral thalamic lesion. Posterolateral thalamic involvement may result in disequilibrium with minimal motor or sensory deficit.1 However, this entity has received less attention in comparison with thalamic sensory, movement, and ataxic disorders. The transient nature of TDS underscores its importance for the prevention of falls in neurorehabilitation. The current report highlights development of TDS due to right thalamic hemorrhage after thrombolytic therapy for acute myocardial infarction. A 65-year-old man underwent thrombolytic therapy for acute anterior wall myocardial infarction with streptokinase followed by heparin and oral antiplatelet agents. When he tried to move 3 days later, he could not stand or walk unassisted. On assisted standing, he had truncal instability with axial lateropulsion to the left. He also required assistance for sitting up in bed. Neurologically he had normal visual fields, cranial nerve function (especially ocular movements), muscle power, and …