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medial medullary syndrome; inferior alternating syndrome; hypoglossal alternating hemiplegia; Dejerine syndrome
Epidemiology:
- rare
- < 1% of vertebrobasilar strokes
Pathology:
- brainstem infarction of the medial medulla supplied by the anterior spinal artery
- ipsilateral medullary pyramid, the medial leminiscus, & hypoglossal nerve fibers that pass through the medulla
- the spinothalamic tract is spared (supplied by vertebral arteries & posterior inferior cerebellar arteries)
- the trigeminal nucleus is also spared
Clinical manifestations:
- ipsilateral deviation of the tongue on attempted protrusion
- contralateral limb weakness or hemiplegia
- contralateral loss of light touch, proprioception & vibration sense
- facial palsy (either side)
- ataxia, vertigo, nystagmus, dysphagia
- palatal & pharyngeal weakness are rare
General
syndrome
brainstem infarction
References
- Medial Medullary Syndrome (Dejerine Syndrome)
Internet Stroke Center
http://www.strokecenter.org/professionals/stroke-diagnosis/stroke-syndromes/medial-medullary-syndrome/
- Wikipedia: Medial medullary syndrome
http://en.wikipedia.org/wiki/Medial_medullary_syndrome