Medial medullary syndrome
Citation, DOI, disclosures and article data
At the time the article was created Ahmed Abdrabou had no recorded disclosures.
View Ahmed Abdrabou's current disclosuresAt the time the article was last revised Rohit Sharma had no financial relationships to ineligible companies to disclose.
View Rohit Sharma's current disclosures- Dejerine syndrome
- Dejerine's syndrome
- Déjerine syndrome
- Déjerine's syndrome
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.
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Epidemiology
Represents less than 1% of brainstem stroke syndromes 1,2.
Clinical presentation
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.
Radiographic features
MRI
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.
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History and etymology
The syndrome was first described by Joseph Jules Déjerine (1849-1917), a French neurologist, in 1915 3.
References
- 1. Bassetti C, Bogousslavsky J, Mattle H et-al. Medial medullary stroke: report of seven patients and review of the literature. Neurology. 1997;48 (4): 882-90. Pubmed citation
- 2. Ropper AH, Samuels MA, Klein JP. Adams and Victor's principles of neurology 10th ed. New York: McGraw-Hill Medical Pub. Division; 2014.
- 3. Dejerine J. Semiologie des affections du systeme nerveux. The Journal of Nervous and Mental Disease. 1915 Nov 1;42(11):780.
- 4. Duarte-Celada W, Montalvan V, Bueso T, Davila-Siliezar P. Bilateral Medial Medullary Stroke: “The Heart Sign”. Radiology Case Reports. 2024;19(4):1329-32. doi:10.1016/j.radcr.2024.01.008 - Pubmed
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- medullary infarct
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- hemimedullary syndrome (Reinhold syndrome)
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- by vascular territory
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intracranial hemorrhage
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intra-axial hemorrhage
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intra-axial hemorrhage
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