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Lateral medullary syndrome: a diagnostic approach illustrated through case presentation and literature review

Published online by Cambridge University Press:  04 March 2015

Gregory S. Day ,
Richard H. Swartz ,
Jordan Chenkin ,
Adil I. Shamji  and
David W. Frost
Gregory S. Day*
Affiliation:
Division of Neurology, Department of Medicine, University of Toronto University Health Network Hospitals
Richard H. Swartz
Affiliation:
Division of Neurology, Department of Medicine, University of Toronto Sunnybrook Health Sciences Centre
Jordan Chenkin
Affiliation:
Sunnybrook Health Sciences Centre Division of Emergency Medicine, Department of Medicine, University of Toronto
Adil I. Shamji
Affiliation:
Department of Family and Community Medicine, University of Toronto
David W. Frost
Affiliation:
University Health Network Hospitals Division of General Internal Medicine, Department of Medicine, University of Toronto Herbert HoPingKong Centre for Excellence in Education and Practice, University of Toronto, Toronto, ON
*
Division of Neurology, University of Toronto, Toronto Western Hospital, 399 Bathurst Street, Toronto, ON M5T 2S8; [email protected]

Abstract

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Patients with lateral medullary syndrome classically present with crossed hemisensory disturbance, ipsilateral Horner syndrome, and cerebellar signs, all of which are attributable to infarction of the lateral medulla. However, variability in the presentation of this syndrome is the rule, as illustrated in this case presentation and literature review. We propose an approach to diagnosis and management of the lateral medullary syndrome and illustrate the need to integrate clinical information with an understanding of brainstem anatomy with the goal of determining which patients require urgent neuroimaging and acute stroke therapies. The importance of recognition of this condition in the emergency department is underscored by the association between lateral medullary infarction and vertebral artery dissection. With optimal therapy, the prognosis for recovery from lateral medullary syndrome is good.

Keywords

lateral medullary infarctlateral medullary syndromeposterior fossastrokevertebral artery dissectionWallenberg syndrome
Type
Case Report • Rapport De Cas
Information
Canadian Journal of Emergency Medicine , Volume 16 , Issue 2 , March 2014 , pp. 164 - 170
Copyright
Copyright © Canadian Association of Emergency Physicians 2014

References

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