Medial medullary syndrome

Last revised by Rohit Sharma on 26 Feb 2024

Medial medullary syndrome, also known as Déjerine syndrome,  is secondary to thrombotic or embolic occlusion of small perforating branches from vertebral or proximal basilar artery supplying the medial aspect of medulla oblongata1,2.

Represents less than 1% of brainstem stroke syndromes 1,2.

It is characterized by contralateral hemiplegia/hemiparesis as well as hemisensory loss with ipsilateral hypoglossal palsy (ipsilateral tongue weakness and atrophy) from involvement of CN XII nucleus 1,2. Other manifestations such as vertigo, nausea, or contralateral limb ataxia are also reported 1,2.

MRI with DWI is the best diagnostic test to confirm the infarct in the medial medulla, whereby the infarcted area has high DWI signal and is low signal on ADC. If bilateral medial medullary infarcts are present, the heart sign may be observed 4.

The syndrome was first described by Joseph Jules Déjerine (1849-1917), a French neurologist, in 1915 3.

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