We studied clinico-lesional correlations in patients with lateral medullary infarction in a tertiary referral center

Infarctions involving the medulla oblongata are rare. Since the description of wallenberg syndrome 100 years ago there are only few studies about clinico-lesional correlations in patients with lateral medullary infarction.

Mean age of study group 51.75. Hypertension was the most common risk factor seen in 60% of our patients. Clinically patients were divided into 3 groups (1.Vertigo, and gait ataxia - 49 %,2. Predominant dysphagia/nasal regurgitation -7% and both groups of symptoms- 44%). There were 3 types of sensory pattern seen in our lateral medullary infarction (LMI) patients (19/29- ipsilateral facial hypalgesia and contralateral (C/L) hemibody hypalgesia, 8/29 - C/L face and body hypoalgesia and 1/29 - whole face hypalgesia). Facial paresis was seen in 8/29 cases. 4/29 cases had hemiparesis of which 3 were due to medial medullary infarction (MMI) and one due to submedullary syndrome of Opalski. MRI showed cerebellar infarcts accompanying LMI in 44%, corpus callosal and occipital lobe infarct in addition to LMI in 7% and the rest 49 % had pure LMI.

Triad of ataxia, Horner’s and C/L hypalgesia is present in >90% of LMI. C/L face and body hypalgesia is the second most common type of sensory loss seen in LMI. Nearly half of patients with LMI were accompanied by cerebellar and other infarcts.Hemiparesis can occur in LMI very rarely due to submedullary syndrome of Opalski.MMI is a very rare syndrome and can present with pure motor hemiparesis and is difficult to localize clinically without lingual palsy.