J Korean Geriatr Soc.  2004 Mar;8(1):35-39.

A Cas e of Bilateral Lateral Medullary Syndrome due to Two Cons ecutive Medullary Infarcts

Affiliations
  • 1Department of Neurology, 415 Bangdong-ri, Sacheon-myeon, Gangwon-do 210-711, Korea. jkd@gnah.co.kr
  • 2Department of Neurology, Kangnung Asan Hospital, University of Ulsan College of Medicine, Kangnung Korea.
  • 3Department of Diagnostic Radiology, Seoul Asan Hospital, Asan Medical University of Ulsan College of Medicine, Seoul, Korea.
  • 4Department of Family Medicine, Seoul Asan Hospital, Asan Medical University of Ul san College of Medicine, Seoul, Korea.
  • 5Department of Neurology, Seoul Asan Hospital, Asan Medical University of Ulsan College of Medicine, Seoul, Korea.

Abstract

Lateral medullary syndrome is one of the most well known and best characterized vascular syndromes of the vertebrobasilar circulation. This syndrome is most often caused by unilateral occlusive disease of the ipsilateral vertebral artery or its posterior inferior cerebellar artery branch. Bilateral lateral medullary syndromes are rare and the prognosis of this condition is grave. A 70-year-old hypertensive, diabetic woman developed sudden dizziness and gait ataxia. On neurologic examination, she had dysarthria, hoarseness, nystagmus, absent gag reflex, sensory changes on the right hemibody, and left limb and gait ataxia. Brain MRI revealed left middle and inferior lateral medullar infarction. Brain MR angiography revealed occlusion of the right vertebral artery and mild stenosis at the origin of the left vertebral artery with distal occlusion. Seven months later, she developed right lateral medullary syndrome. Repeated brain MRI revealed right upper lateral medullar and cerebellar infarction. We report a case of bilateral lateral medullary syndromes due to two consecutive medullary infarcts.

Keyword

Lateral medullary syndromes; Medullar oblongata; Brainstem infarction

MeSH Terms

Aged
Angiography
Arteries
Brain
Brain Stem Infarctions
Constriction, Pathologic
Dizziness
Dysarthria
Extremities
Female
Gait Ataxia
Hoarseness
Humans
Infarction
Lateral Medullary Syndrome*
Magnetic Resonance Imaging
Neurologic Examination
Prognosis
Reflex
Vertebral Artery
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