The 'thalamus' is the part of the brain where many different functions are processed. It acts as a relay center in the brain, where various impulses come, and go, to and from different parts of the body. The thalamus is responsible for regulating the levels of sleep, and consciousness in a person. One of the common pathologies that could affect the function of the thalamus is a stroke that occurs due to restricted supply of blood to this portion of the brain, which in turn may lead to infarction of that region of the brain. More often than not, a person manages to recover from a stroke; however a small percentage of people could be affected by this syndrome.
The exact etiology of this syndrome is not known. This syndrome is also known as 'Dejerine-Roussy disease', named after Joseph Dejerine, a neurologist and Gustave Roussy, a neuropathologist. It has been observed that an initial stroke to the region of the thalamus may lead to loss of sensation, or disturbed sensation in the opposite side of the body (as the right side of the brain controls the left side of the body and vice versa). Therefore, the person may still sense pain in the initial phase of recovery. Furthermore, if this pain persists for weeks, or even months after the stroke, then it is indicative of post thalamic pain syndrome.
Initially, the symptoms may include pain, and slight stinging sensation, which may occur in one part, or throughout the entire body. While this pain may initially be mild, and stinging in nature, it often eventually transgresses into severe, and unbearable pain, mimicking stroke symptoms. This pain could be either dull, and gnawing at all times, or may progress to a severe and unbearable condition. The nature of pain varies from person to person; while some people claim that this pain is lancinating and throbbing in nature, others complain of a burning sensation.
The sad part is that even though the symptoms may improve over the course of time, more often than not, the syndrome and the pain associated with it is permanent. Thus, the course of treatment is a prolonged one, where trial and error is the only way to proceed. Due to the nature of the pain, the normal painkillers are not strong enough to bring about any kind of substantial relief. Hence, these analgesics are usually combined with narcotics, although off late, epileptic drugs have also shown encouraging results. In cases where the pain is absolutely unrelenting, intense and invasive pain management options such as pumps that are implanted directly in the spinal cord, and which deliver medication there, surgical destruction of a portion of the thalamus, or deep brain stimulation, can be opted. None of these treatment options guarantee results, and the outcome, and the degree of relief obtained, might be different for each patient.
As difficult is the treatment, so is establishing a diagnosis of this condition. This condition is usually diagnosed by an expert neurologist. This is a condition that is relatively rare, but statistics do not matter to the affected people. Hence, when people with a history of strokes develop the aforementioned symptoms, thalamic pain syndrome must be considered as a possible diagnosis.
Disclaimer: This HealthHearty article is for informative purposes only, and should not be used as a replacement for expert medical advice.