Combined thalamic ptosis and astasia

Isolated cases of astasia or ptosis have each been reported in ischemic or hemorrhagic strokes involving the thalamus. We report a 70-year-old man with a medical history of hypertension who presented with left ptosis and gait disturbance despite intact motor strength in the legs and normal sensory function. MRI of the brain showed an evolving subacute infarction confined to the anteromedial-medial part of the left thalamus with no other areas of recent infarction identified. To our knowledge, combined ptosis and astasia in thalamic infarction has not been reported in the English literature. We identified 11 patients with thalamic ptosis and 21 with thalamic astasia in the literature. Patients who had ptosis, or gait abnormality which would not be related to thalamic stroke, were excluded; for example, evidence of infarction in the hypothalamus, midbrain, pons, cerebellum, or cingulate gyrus.