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Pure Sensory Stroke – Thalamic Lacunar — SCE Neurology MCQ

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EasyCerebrovascular DiseasePure Sensory Stroke – Thalamic LacunarSCE Neurology

A 60-year-old woman with a left thalamic stroke has a pure sensory deficit affecting the right face, arm, and leg equally. She has numbness and tingling but NO weakness, NO visual field cut, and NO aphasia. What is this lacunar syndrome?

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Correct answer: B — Pure sensory stroke — from a lacunar infarct of the ventral posterolateral (VPL) nucleus of the thalamus

Pure sensory stroke is a classic lacunar syndrome resulting from a small vessel infarct in the ventral posterior thalamus (VPL nucleus for body sensation, VPM for face). It presents with contralateral hemisensory loss (face, arm, leg) affecting all modalities WITHOUT motor, visual, or cortical deficits. It may evolve into thalamic pain syndrome (Déjerine-Roussy). A: Pure motor has weakness without sensory loss. C: Sensorimotor has both. D: Ataxic hemiparesis has cerebellar-type ataxia + weakness. E: Dysarthria-clumsy hand has speech + hand clumsiness.

Reference: RCP Stroke Guidelines; TOAST Classification