Thalamic chronotaraxis: Isolated time disorientation

Abstract

Background: Acute isolated disorientation of time, chronotaraxis, is an uncommon manifestation of thalamic stroke. To our knowledge, acute thalamic chronotaraxis with MRI findings has not previously been reported. Objective: To describe five patients with chronotaraxis after thalamic stroke and attempt to demonstrate the correlation between lesion location and neurological findings. Patients, methods and results: Isolated time disorientation and loss of time sense were found in five of 120 patients (4%) with ischaemic thalamic stroke in our centre. All patients had disorientation to actual date, inability to know the exact time of the day and under or overestimation of the time passed during examination. Patients expressed themselves as having time blindness with an inability to estimate and guess the actual time. Conclusion: Acute thalamic chronotaraxis is a specific clinical picture that accurately predicts a small artery disease of the thalamus involving the mediodorsal nucleus of the thalamus. This clinical syndrome appears to have a good clinical recovery.