What is Dejerine-Roussy Syndrome or Thalamic Pain Syndrome?

Dejerine-roussy syndrome or thalamic pain syndrome is also referred to as Central Pain Syndrome (CPS). It is a very rare neurological condition in which a stroke to the part of the human brain which controls sensation ie., thalamus, results in excessive pain in response to reduced sensation or mild stimulation. The face, as well as the limbs, are those parts of the body which are mostly affected because of a thalamic stroke.

What is Dejerine-Roussy Syndrome or Thalamic Pain Syndrome?

Causes of Dejerine-Roussy Syndrome or Thalamic Pain Syndrome

Any sort of a condition which can cause damage to the thalamus can cause dejerine-roussy syndrome or thalamic pain syndrome:

  1. Parkinson's disease.
  2. Bleeding in the brain.
  3. Brain conditions.
  4. Circulatory system conditions.
  5. Nervous system conditions.
  6. Pain conditions.

Other conditions which can cause dejerine-roussy syndrome or thalamic pain syndrome are:

  1. Stroke.
  2. Trauma to the head can cause dejerine-roussy syndrome or thalamic pain syndrome.
  3. Tumor.

Symptoms of Dejerine-Roussy Syndrome or Thalamic Pain Syndrome

The symptoms of dejerine-roussy syndrome or thalamic pain syndrome are as follows:

  • Abnormal sensation of cold on one side of body.
  • Abnormal sensation of heat on one side of body.
  • Choreoathetoid movements.
  • Cramps and muscle spasm.
  • Emotional overreaction.
  • Feeling abnormal pain upon normal stimulation e.g. when you lightly touch the skin.
  • Hemiataxia.
  • Low muscle tone which results in the in wasting of the muscles and muscle weakness can be a symptom of dejerine-roussy syndrome or thalamic pain syndrome.
  • Pain – It ranges from mild to debilitating.
  • Pain hypersensitivity.
  • Sideways curvature of the spine.
  • Speaking difficulty is also a symptom of dejerine-roussy syndrome or thalamic pain syndrome.
  • The feet and hands deformities in the foot because of severe muscle contractures.
  • The movement condition is very poor because of the low muscle tone. If there is a weakness in the arm it can n affect the ability to perform fine motor skills? The poor condition can also affect your ability to balance and walk. It also results in a high incidence of falls.
  • Tingling sensation on one side of body.
  • Weakness on one side of the body can also be a symptom of dejerine-roussy syndrome or thalamic pain syndrome.

Tests to Diagnose Dejerine-Roussy Syndrome or Thalamic Pain Syndrome

In order to confirm damage to pain conducting pathways Laser Evoked Potentials are rarely needed. They are also not available on a routine basis.

Treatment for Dejerine-Roussy Syndrome or Thalamic Pain Syndrome

Physiotherapy is a crucial treatment method for relieving the symptoms of dejerine-roussy syndrome or thalamic pain syndrome as it highlights the progression of the condition. A thorough assessment of your needs will be conducted by your physiotherapist. After that, they will chalk out an individual treatment program for you so that you are able to reach your full potential. They will also provide you with a treatment plan which will be focused on assisting in maintaining as much movement and functional independence as possible.

There have been a lot of medicines used for many different types of pain related to neuropathy as well for dejerine-roussy syndrome or thalamic pain syndrome. You cannot treat the symptom with normal analgesics. Traditional chemicals consist of anti-depressants and opiates. The latest medicines incorporate Kampo medicine and anti-convulsions. You can administer pain treatments with oral medication or periodic injections. Asides from this physical therapy (PT) have been in practice in combination with medicines. In recent times, as treatment methods, power stimulation of brain caloric stimulation and the spinal cord are also investigated.

Numerous medications are being used in the treatment of CPS (Central Pain Syndrome) despite the fact all of them are not completely effective in getting rid of the symptoms. It is via the trial and error method that the doctors along with their patients eventually find the medications which are meant for each specific case. It becomes necessary to locate regime that allows for the maximum quality of life for each patient. The most common medications used in the treatment of CPS (Central Pain Syndrome) are listed here:

  • Antidepressants, Anticonvulsants, benzodiazepines, antispasmodics/anticholinergics, local anesthetics (transdermal cream and patches), CNS stimulants, muscle relaxants, medical marijuana (ingested, inhaled and even topically applied), neuroleptics, narcotic pain medications as well as sedatives and sleeping aids.
  • Medications will be different as they will be based on the precursory condition which has led to this dreadful disease as well as any other such medical issues which a patient may be receiving treatment for.
  • As the chronic pain will in all probability get worse with vitamin D deficiency, you should see to it that the vitamin D levels are within normal limits. Depression and fatigue which are commonly found in this disease can also be improved when you add some vitamin D supplement.
  • Other than medications, there are no other treatments known to trigger the CPS symptoms. However, biofeedback, stress reduction and staying away from certain triggers do assist certain patients to keep their pain at more tolerable levels.

A very common treatment plans dejerine-roussy syndrome or thalamic pain syndrome are made up of a schedule of physical therapy along with a medication regimen. The reason for this is that the pain will not change after development and that there a lot of patients that test different medications. They then select that medication which is best able to adapt to their lifestyle, the most common of which are intravenously and orally administered.

Prevention of Dejerine-Roussy Syndrome or Thalamic Pain Syndrome

Little chunks of clot whittle away from a big clot and get stuck somewhere down the "river". It is only by finding the source of the little flying chunks that dejerine-roussy syndrome or thalamic pain syndrome can be prevented. If you wish to prevent this dreadful disease then stay away from alcohol as it dissolves the big clot which can suddenly dislodge causing a stroke.

Risk Factors for Dejerine-Roussy Syndrome or Thalamic Pain Syndrome

The risk factors which are identified with dejerine-roussy syndrome or thalamic pain syndrome are that a stroke usually damages one part of the human brain, including the thalamus. Generally, thalamus in the brain is said to send sensory data among cerebral cortex and different types of subcortical parts. We are aware that the sensory data from the our surroundings go to the thalamus for data process. It, later on, travels to somatosensory-cortex in order for you to understand. It finally allows the person to feel, hear or see things as processed by your brain. It also compromises of tactile sensation. This is why if there is any injury in the region of thalamus, it results in unclear communication amid the afferent cortex and the pathway of your brain, altering the how or what one feels.

Complications of Dejerine-Roussy Syndrome or Thalamic Pain Syndrome

The disease dejerine-roussy syndrome or thalamic pain syndrome is poor when it comes to a normal sensory input: sound, light, vibrations, movement, stress emotions, and even thinking. A breeze and even a hug or a light touch and even clothes which touch the skin results in intense, burning pain. Touching a hot/cold item such as a coffee mug, door handle, steering wheel or water faucet, can cause pain a range of different areas in the body as well as to the to the hand that touches it. The pain makes no sense. Barometric pressure changes like a storm coming and going and the altitude is able to wreak disaster on a CPS sufferer. dressing, Showering, sitting on a hot/ cold car seat, walking outside into the daylight, riding in a car which reverberates while going down the road and touching the warm/cool steering wheel can blend together with the pain a CPS patient feels.

Prognosis/Outlook for Dejerine-Roussy Syndrome or Thalamic Pain Syndrome

The prognosis or outlook for dejerine-roussy syndrome or thalamic pain syndrome is not good. Previously this disease was listed as a non-fatal condition. However, now as the pain shoots to unthinkable levels, so can blood pressure. There are patients who are prone to strokes, an increase in blood pressure will prove fatal for them. Patients are also likely to commit suicide in the CPS community as the pain never vanishes, it, however, does get worse over a period of time and is very difficult to effectively treat the disease.

Lifestyle Changes for Dejerine-Roussy Syndrome or Thalamic Pain Syndrome

The methods to instill a long-term commitment to a physically active lifestyle should be initiated at the time of formal stroke rehabilitation, but evidence to guide intervention is lacking. It is also necessary to foster exercise self-efficacy is particularly important to ease the transition from structured, an institution based aerobic training to home- and community-based physical activity.

Also Read:

Written, Edited or Reviewed By:

, MD, FFARCSI

Last Modified On: May 2, 2017

Pain Assist Inc.

Pramod Kerkar
  Note: Information provided is not a substitute for physician, hospital or any form of medical care. Examination and Investigation is necessary for correct diagnosis.

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