A 65-year-old hypertensive, diabetic man presents with sudden onset numbness and tingling affecting the entire right side of the body, including the face, arm, leg, and trunk, in an equal distribution. There is no weakness, no visual field deficit, and no aphasia. CT head is normal. MRI diffusion-weighted imaging shows a small acute infarct in the left ventral posterolateral nucleus of the thalamus. Which lacunar syndrome best explains this presentation?

• A Pure sensory stroke ✓
• B Ataxic hemiparesis
• C Pure motor hemiparesis
• D Dysarthria-clumsy hand syndrome

Explanation

Pure sensory stroke results from a small lacunar infarct in the ventral posterior thalamus (VPL/VPM nuclei), causing contralateral hemisensory loss involving face, arm, leg, and trunk equally, without motor deficits or cortical signs. Pure motor hemiparesis involves face, arm, and leg equally but with weakness, not sensory loss. Ataxic hemiparesis combines weakness with ipsilateral incoordination. Dysarthria-clumsy hand involves facial weakness, dysarthria, and hand clumsiness without sensory findings.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.