EpistemisHemihypoesthesia
Specialty: Neurology.
Why it occurs
- Ischemic or hemorrhagic stroke located in the posterolateral ventral nucleus of the thalamus or in the contralateral parietal somatosensory cortex
- Contralateral parietal lobar brain tumor with perilesional edema
- Active demyelination plaque in the brain stem or upper cervical spinal cord
- Chronic subdural hematoma with progressive cortical compression
- Medullary Brown-Séquard syndrome (thermoalgesic hemihypoesthesia contralateral to the motor lesion)
Initial workup
Urgent simple head CT or emergency brain MRI with diffusion sequences (DWI); Angio-CT or Angio-MR of cerebral vessels; transesophageal echocardiogram and electrocardiogram if embolism of cardiac origin is suspected.
red flags
Loss of sensitivity of one hemibody of acute and unexpected onset, associated with deviation of the lip commissure, weakness of the right or left extremities, or difficulty articulating language (aphasia/dysarthria), which represents an acute stroke code.
Standard management
- Recombinant type tissue plasminogen activator (rTPA) or Tenecteplase if it occurs within the therapeutic windows of ischemic stroke
- Acetylsalicylic acid as secondary prevention
- Dexamethasone if there is a demonstrated tumor mass effect.
Educational guidance for study. It is NOT a prescription recommendation. The actual choice depends on the cause, the patient, and current guidelines.
- Area
- Neurology
- Listed causes
- 5
- Treatment options
- 3