Electromyographic (EMG) biofeedback in the comprehensive treatment of central pain and ataxic tremor following thalamic stroke

Peripheral pain and ataxic tremor can appear suddenly following thalamic st roke and can significantly alter a patient's psychological, social, and phy sical functioning. The present paper reports the case of a 70-year-old Cauc asian female who sustained an acute left posterior cerebral artery infarcti on involving the thalamus and left mesiotemporal regions. She subsequently developed Central Poststroke Pain and ataxic movement of her right arm and hand in addition to a significant right-side claudication. She was treated over 16 weeks (6 weeks of EMG biofeedback and 10 weeks of psychotherapy) wi th a combination of EMG biofeedback, progressive muscle relaxation, behavio ral pain coping skills training Forced Use Therapy, and Cognitive Behaviora l Therapy 7 years after her initial cerebral accident. The case demonstrate s the utility of biofeedback when combined as part of a comprehensive treat ment program to address the multiple complications associated with thalamic stroke.