Opalski syndrome

Last revised by Dr Rohit Sharma on 01 Jun 2021

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.

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.

Opalski syndrome is extremely rare, however most case reports detail ischemic stroke as the cause 1-4.

Lesions are in medulla with imaging characteristics depending on underlying cause 1-4.

The syndrome was first described by Adam Opalski (1897-1963), a Polish physician, in 1946 5,6.

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