Cheiro-Oral Syndrome as a Clinical Clue to Thalamic Lacunar Infarction: A Case Report and Review of Diagnostic Challenges

Lacunar infarcts represent a specific category of ischemic strokes that impact deep penetrating arteries. Cheiro-oral syndrome (COS) is a rare neurological manifestation of lacunar infarcts, marked by sensory disturbances in the perioral area and the ipsilateral hand. We report a 56-year-old male presented with recurrent right-sided paresthesias affecting the face, tongue, and upper limb. Ultimately leading to a diagnosis of a lacunar infarct in the left lateral thalamus. Initial CT brain was unremarkable; however, MRI brain indicated an acute lacunar infarct in the left thalamus. This case highlights the clinical significance of identifying COS as a manifestation of thalamic stroke and stresses the necessity for heightened clinical suspicion and prompt MRI in atypical presentations to facilitate timely secondary prevention.