Opalski syndrome
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Opalski syndrome is a very rare brainstem stroke syndrome similar to Babinski-Nageotte syndrome, however, the medullary lesion extends beyond decussation of the corticospinal tracts into the upper cervical cord.
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Clinical presentation
Opalski syndrome is considered to be a spreading of the “Wallenbergian” lateral lesion caudally to the corticospinal tracts after their decussation, resulting in the lateral medullary syndrome with ipsilateral hemiparesis/hemiplegia 1-4. The pattern of weakness differentiates it from Babinski-Nageotte syndrome whereby the lesion is limited to before decussation, and thus there is contralateral hemiparesis/hemiplegia instead 1.
Pathology
Opalski syndrome is extremely rare, however most case reports detail ischemic stroke as the cause 1-4.
Radiographic features
Lesions are in medulla with imaging characteristics depending on underlying cause 1-4.
History and etymology
The syndrome was first described by Adam Opalski (1897-1963), a Polish physician, in 1946 5,6.
References
- 1. Pandey S, Batla A. Opalski's syndrome: A rare variant of lateral medullary syndrome. (2013) Journal of neurosciences in rural practice. 4 (1): 102-4. doi:10.4103/0976-3147.105642 - Pubmed
- 2. Dhamoon SK, Iqbal J, Collins GH. Ipsilateral hemiplegia and the Wallenberg syndrome. (1984) Archives of neurology. doi:10.1001/archneur.1984.04050140077029 - Pubmed
- 3. Nakamura S, Kitami M, Furukawa Y. Opalski syndrome. (2010) Neurology. 75 (18): 1658. doi:10.1212/WNL.0b013e3181fb4479 - Pubmed
- 4. Kimura Y, Hashimoto H, Tagaya M, Abe Y, Etani H. Ipsilateral hemiplegia in a lateral medullary infarct--Opalski's syndrome. (2003) Journal of neuroimaging : official journal of the American Society of Neuroimaging. doi:10.1111/j.1552-6569.2003.tb00162.x - Pubmed
- 5. Opalski A. A new sub-bulbar syndrome: partial syndrome of the posterior vertebro-spinal artery. Paris Med. 1946;1946:214–220.
- 6. Rytel L, Lech P, Szymanska K, Gonkowski S. Adam Opalski (1897-1963). (2018) Journal of neurology. 265 (7): 1730-1731. doi:10.1007/s00415-017-8704-8 - Pubmed
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