{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T21:29:21Z","timestamp":1790976561013,"version":"4.1.0"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[1999,10]]},"abstract":"<jats:p>\n            <jats:italic>Background<\/jats:italic>\n            \u2014The aim of the study was to assess the consequences of severe spinothalamic tract lesions resulting from lateral medullary infarct and to show that a specific pain perception can be elicited by strong thermal stimulation.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Case Descriptions<\/jats:italic>\n            <jats:italic>\u2014<\/jats:italic>\n            Both patients examined presented with severe thermoalgic dissociation of the limbs contralateral to the lesion, with normal discriminative somatosensory perception and motor strength. They reported pain perception when touching very warm (&gt;50\u00b0C to 60\u00b0C) objects and a brisk, occasionally uncontrolled withdrawal reaction of the arm and hand under the same conditions, without any perception of the heat nature of the stimulus. Warm stimulation, &lt;45\u00b0C, elicited no thermal perception or discrimination. Pain perception could be elicited in both patients by increasing the temperature, with a reproducible threshold of 47\u00b0C to 49\u00b0C. Pain always occurred after a prolonged delay of 8 to 10 seconds in response to threshold heat, and was described as deep and osseous, and clearly different from that perceived on the nonaffected side. The delay was much shorter when the temperature was increased by 4\u00b0C to 5\u00b0C. Cold stimulation elicited similar pain perception in one patient. Analysis of subjective perception of laser stimulation showed a much higher pain threshold on the affected hand. There were no laser-evoked potentials on this side, which suggested major spinothalamic injury. Assessment of the RIII noxious reflex revealed persistent response withdrawal reactions, with an increased threshold on the affected side, and partial consciousness of the noxious nature of the stimulus.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Conclusions<\/jats:italic>\n            \u2014To our knowledge, this is the first description of the appearance of pain perception of high temperatures in patients with severe spinothalamic injury who are suffering from a complete loss of temperature perception. This implies that noxious thermal stimulation can still be perceived via extra spinothalamic pathways (which are slow and multisynaptic), such as the spinoreticulothalamic tract. Patients with Wallenberg syndrome should be informed and made aware of their residual perception of and reactions to noxious stimulation.\n          <\/jats:p>","DOI":"10.1161\/01.str.30.10.2223","type":"journal-article","created":{"date-parts":[[2011,6,17]],"date-time":"2011-06-17T20:08:03Z","timestamp":1308341283000},"page":"2223-2229","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":18,"title":["Analysis of the Perception of and Reactivity to Pain and Heat in Patients With Wallenberg Syndrome and Severe Spinothalamic Tract Dysfunction"],"prefix":"10.1161","volume":"30","author":[{"given":"M.","family":"Rousseaux","sequence":"first","affiliation":[{"name":"From the Service de Re\u0301e\u0301ducation Neurologique (M.R., B.B.), Ho\u0302pital Swynghedauw, Centre Hospitalier Universitaire (CHU), and the Service de Neurophysiologie Clinique (F.C., E.L.), Ho\u0302pital Salengro, Centre Hospitalier Universitaire (CHU), Lille, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Cassim","sequence":"additional","affiliation":[{"name":"From the Service de Re\u0301e\u0301ducation Neurologique (M.R., B.B.), Ho\u0302pital Swynghedauw, Centre Hospitalier Universitaire (CHU), and the Service de Neurophysiologie Clinique (F.C., E.L.), Ho\u0302pital Salengro, Centre Hospitalier Universitaire (CHU), Lille, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Bayle","sequence":"additional","affiliation":[{"name":"From the Service de Re\u0301e\u0301ducation Neurologique (M.R., B.B.), Ho\u0302pital Swynghedauw, Centre Hospitalier Universitaire (CHU), and the Service de Neurophysiologie Clinique (F.C., E.L.), Ho\u0302pital Salengro, Centre Hospitalier Universitaire (CHU), Lille, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Laureau","sequence":"additional","affiliation":[{"name":"From the Service de Re\u0301e\u0301ducation Neurologique (M.R., B.B.), Ho\u0302pital Swynghedauw, Centre Hospitalier Universitaire (CHU), and the Service de Neurophysiologie Clinique (F.C., E.L.), Ho\u0302pital Salengro, Centre Hospitalier Universitaire (CHU), Lille, France."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_1_2","unstructured":"Jones SL. Anatomy of pain. In: Sinatra RS Hord AH Ginsberg B Prebel LM eds. Acute Pain Mechanisms and Management. St Louis Mo: Mosby Year Book; 1992:8\u201328."},{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/00004691-199701000-00002"},{"key":"e_1_3_1_3_2","unstructured":"Currier RD. Syndromes of the medulla oblongata. In: Vinken PJ Bruyn GW Biemond A eds. Handbook of Clinical Neurology Vol 2. Amsterdam Netherlands: North-Holland Publishing Co; 1969:217\u2013237."},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.38.10.1515"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/118.4.1013"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.49.6.1557"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/113.4.1223"},{"key":"e_1_3_1_8_2","doi-asserted-by":"crossref","unstructured":"Garcia-Larrea L Maugui re F. Electrophysiological assessment of nociception in normals and patients: the use of nociceptive reflexes. In: Rossini PM Maugui re F eds. New Trends and Advanced Techniques in Clinical Neurophysiology (EEG Suppl 41). Amsterdam Netherlands: Elsevier; 1990:102\u2013118.","DOI":"10.1016\/B978-0-444-81352-7.50013-3"},{"key":"e_1_3_1_9_2","first-page":"345","volume":"1221","year":"1998","unstructured":"Peyron R, Garcia-Larrea L, Gr\u00e9goire MC, Convers P, Lavenne F, Veyre L, Froment JC, Maugui re F, Michel D, Laurent B. Allodynia after lateral-medullary (Wallenberg) infarct: a PET study. Brain. 1998;1221:345\u2013356.","journal-title":"Brain"},{"key":"e_1_3_1_10_2","unstructured":"Treede RD. Assessment of thin-fiber and anterolateral-tract function with laser evoked potentials. In: Kimura J Shibasaki H eds. Recent Advances in Clinical Neurophysiology. Amsterdam Netherlands: Elsevier; 1996:323\u2013327."},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.27.5.991"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/100.4.641"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/109.5.1003"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.53.11.935"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(90)91087-Y"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1995.83.1.0008"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/00004691-199607000-00007"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1985.04060080104023"},{"key":"e_1_3_1_19_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0404.1996.tb07043.x"},{"key":"e_1_3_1_20_2","first-page":"625","volume":"147","year":"1991","unstructured":"Bromm B, Treede RD. Laser-evoked cerebral potentials in the assessment of cutaneous pain sensitivity in normal subjects and patients. Rev Neurol (Paris). 1991;147:625\u2013643.","journal-title":"Rev Neurol (Paris)"},{"key":"e_1_3_1_21_2","first-page":"284","volume":"80","year":"1991","unstructured":"Bromm B, Frieling A, Lankers J. Laser-evoked brain potentials in patients with dissociated loss of pain and temperature sensibility. EEG Clin Neurophysiol. 1991;80:284\u2013291.","journal-title":"EEG Clin Neurophysiol"},{"key":"e_1_3_1_22_2","doi-asserted-by":"crossref","unstructured":"Gibson SJ Gorman MM Helme RD. Assessment of pain in the elderly using event-related cerebral potentials. Pain. 1990(suppl)5:S21.","DOI":"10.1016\/0304-3959(90)92179-T"},{"key":"e_1_3_1_23_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/115.3.893"},{"key":"e_1_3_1_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(95)00143-3"},{"key":"e_1_3_1_25_2","first-page":"261","volume":"1","year":"1982","unstructured":"Tasker RR. Identification of pain processing systems by electrical stimulation of the brain. Human Neurobiol. 1982;1:261\u2013272.","journal-title":"Human Neurobiol"},{"key":"e_1_3_1_26_2","doi-asserted-by":"publisher","DOI":"10.1152\/jn.1990.63.3.473"},{"key":"e_1_3_1_27_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/121.5.931"},{"key":"e_1_3_1_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(76)90079-8"},{"key":"e_1_3_1_29_2","doi-asserted-by":"publisher","DOI":"10.1002\/cne.902070106"},{"key":"e_1_3_1_30_2","doi-asserted-by":"publisher","DOI":"10.1002\/cne.903350402"},{"key":"e_1_3_1_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(96)03127-2"},{"key":"e_1_3_1_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(93)90143-D"},{"key":"e_1_3_1_33_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/110.6.1497"},{"key":"e_1_3_1_34_2","doi-asserted-by":"crossref","unstructured":"Willis WD. Anatomy and physiology of descending control of nociceptive responses of dorsal horn neurons: comprehensive review. In: Pields HL Besson JM eds. Progress in Brain Research Vol 77. Amsterdam Netherlands: Elsevier; 1988:1\u201329.","DOI":"10.1016\/S0079-6123(08)62776-4"},{"key":"e_1_3_1_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/0006-8993(89)91036-6"},{"key":"e_1_3_1_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/0006-8993(77)90732-6"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/01.STR.30.10.2223","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T22:30:22Z","timestamp":1715553022000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/01.STR.30.10.2223"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1999,10]]},"references-count":36,"journal-issue":{"issue":"10","published-print":{"date-parts":[[1999,10]]}},"alternative-id":["10.1161\/01.STR.30.10.2223"],"URL":"https:\/\/doi.org\/10.1161\/01.str.30.10.2223","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[1999,10]]},"assertion":[{"value":"1999-04-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"1999-06-28","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"1999-10-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}