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Findings that shed new light on the possible pathogenesis of a disease or an adverse effect
Somatotopic mismatch following stroke: a pathophysiological condition escaping detection
  1. Ingvars Birznieks1,2,
  2. Inara Logina3,
  3. Gunnar Wasner4
  1. 1School of Science and Health, University of Western Sydney, Penrith, New South Wales, Australia
  2. 2Neuroscience Research Australia, Randwick, Sydney, New South Wales, Australia
  3. 3Department of Neurology, Riga Stradins University, Riga, Latvia
  4. 4Department of Neurology and the Division of Neurological Pain Research and Therapy, University Clinic of Schleswig-Holstein, Kiel, Germany
  1. Correspondence to Dr Ingvars Birznieks, i.birznieks{at}


Clinical evaluation of somatosensory deficits in stroke patients is very limited and usually does not include testing of somatotopic organisation, which is a prerequisite for meaningful interpretation of sensory input and sensorimotor control. Detailed tactile testing of the left hand of a 54-year-old patient suffering from sensory deficit and central pain after a right-sided stroke revealed severe distortion of somatotopic sensory maps as evidenced by incorrect localisation of the point stimuli. Unlike previously reported gross somatotopic remapping taking place within reduced representational space after lesion, this is the first case report revealing chaotic scrambled somatosensory maps. While the incidence of such scrambled somatotopic representation of tactile input is not yet known in stroke patients, current observations indicate that in-depth investigations of somatotopic organisation of affected area may reveal the underlying cause for various functional deficits including central pain. Thus, new rehabilitation strategies may need to be developed specifically for such patients.

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