Lateral medullary syndrome

Case contributed by Dr Sinéad Culleton

Presentation

Presented with ataxia and cerebellar signs.

Patient Data

Age: 55-year-old
Gender: Male
CT

CT Brain (selected image)

Selected image from a non-contrasted CT Brain showing a focus of hypoattenuation in the left lateral medulla in keeping with an infarct.

MRI

MRI Brain (selected images)

Focus of restricted diffusion within the left lateral medulla in keeping with an acute infarct, likely secondary to occlusion of the left posterior inferior cerebellar artery. Corresponding high signal on T2 and FLAIR weighted imaging.

Case Discussion

Lateral medullary syndrome is due to infarction in the lateral part of the medulla.

There are some neurological symptoms as a result of damage to the following areas:

  • dysphagia, dysphonia and dysarthria usually result from damage to the nucleus ambiguous
  • the absence of ipsilateral facial pain and corneal reflex-damage to the spinal trigeminal
  • loss of pain and temperature sensation-damage to the spinothalamic tract
  • ataxia- cerebellar and inferior peduncle damaged
  • nystagmus and vertigo-region of Deiters’ nucleus and other vestibular nuclei.
  • palatal myoclonus-central tegmental tract 1
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Case information

rID: 40549
Case created: 26th Oct 2015
Last edited: 20th Nov 2015
Inclusion in quiz mode: Included

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