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Medial Medullary Syndrome

Presentation

[…] comparatively rare, with hypoglossal neuropathies reported in only several cases of MADSAM. 2, 3, 4 A case report demonstrated hypoglossal neuropathy in a patient masquerading as motor neuron disease. 4 Inconsistent with that case, the symptoms in the present [synapse.koreamed.org]

Pulmonary embolism can present with sudden onset dyspnea, which can lead to death. Patients with hemiplegia may develop bedsores. [ncbi.nlm.nih.gov]

Sarcoidosis presenting as Wallenberg syndrome and panuveitis. Respir Med Case Rep. 2018;24:16-8. [ Links ] 9. Stengl KL, Buchert R, Bauknecht H, Sobesky J. [scielo.org.mx]

INTRODUCTION Strokes in the distribution of the posterior circulation may present vertigo, imbalance and nystagmus [ 1 ]. A stroke involving the brain stem and cerebellum frequently presents acute vestibular syndrome [ 2 ]. [academic.oup.com]

It is our ambition to present a complete survey of all medical phenomena named for a person, with a biography of that person. Disclaimer: Whonamedit? does not give medical advice. [whonamedit.com]

Entire Body System

  • Pain

    Originally released January 10, 2000; last updated January 5, 2019; expires January 5, 2022 This article includes discussion of central neuropathic pain, central pain syndrome, thalamic pain, neurogenic pain, and Dejerine-Roussy syndrome. [medlink.com]

    Spinothalamic tract: mediates pain and temperature sensations from the body to the thalamus. Image : “Vertebral artery based on 3d surface rendered CTA.” by Frank Gaillard – Own work. [lecturio.com]

    She noted the laterality of pain between the right arm and the left arm when her blood was being drawn through a sampling needle: less pain on the left arm. [academic.oup.com]

    We report a ca s e of recurrent Zieve' s s yndrome, con s i s ting of jaundice, hemolytic anemia and hyperlipopro [Radicular pain revealing Hodgkin' s di s ea s e]. [mdmooc.org]

    Temperature, pain, and vibration sensations were disturbed in the lower limbs below the knees. Reflexes were absent in the upper limbs and decreased in the lower limbs. The Romberg sign was positive. [synapse.koreamed.org]

  • Surgical Procedure

    The first recorded surgical procedure for relief of central thalamic pain, a spinothalamic cordotomy, was performed by Frazier in 1937 ( Frazier et al 1937 ). [medlink.com]

Cardiovascular

  • Hypertension

    More often due to a systemic cause such as hypertension and atherosclerosis, medial medullary syndrome is often bilateral with worse prognosis. [lecturio.com]

    Primary medullary hypertensive hemorrhage. Neurology 1985 ; 35 : 925 –928. 45. Kwon HM, Park JM, Lee JY, Yoon BW. Primary medullary hemorrhage associated with hypertension. J Clin Neurol 2005 ; 1 : 177 –179. 46. Barinagarrementeria F, Cantu C. [cambridge.org]

    Common risk factors are dyslipidemia, hypertension, diabetes, and smoking. Other risk factors are atrial fibrillation, atrial septal defect, patent foramen ovale, migraine, and Takayasu arteritis. [ncbi.nlm.nih.gov]

    The medical history of the patient was unremarkable in spite of hypertension. On arrival, she was alert, cooperative, oriented, complaining of vertigo and suffering from nausea. [academic.oup.com]

Neurologic

  • Vertigo

    Vascular vertigo is known to usually accompany other neurologic symptoms and signs [ 2 ]. Appropriate bedside evaluation is superior to MRIs for detecting central vascular vertigo syndromes [ 1 ]. [academic.oup.com]

    Symptoms and Diagnosis of Medullary Syndrome Frequently being acute ischemic events, brain stem strokes are characterized by vomiting, vertigo, diplopia, headache, ataxia, hiccups and dysarthria. [lecturio.com]

  • Dizziness

    Acute diagnosis and management of stroke presenting dizziness or vertigo. Neurol Clin 2015 ; 33 : 687 – 98. 3. The crossed paralyses. The original brain-stem syndromes of Millard-Gubler, Foville, Weber, and Raymond-Cestan. [academic.oup.com]

  • Tremor

    Tract involved in lateral medullary syndrome Manifestation Inferior cerebellar peduncle Ipsilateral ataxia, ipsilateral appendiceal cerebellar signs as dysmetria, intentional tremors Vestibular nuclei Vomiting, vertigo, nystagmus, diplopia. [lecturio.com]

Treatment

Treatment / Management Management of medial medullary syndrome is similar to any acute ischemic stroke. A rapid evaluation of the patient is necessary for proper management. [ncbi.nlm.nih.gov]

Although there have been advances in understanding the pathophysiology of pain and several new methods of treatment, management of neuropathic pain remains a difficult problem. Classification. [medlink.com]

In Berlin the use of electricity in diagnosis and treatment was given by Martin Bernhardt (of the Bernhardt-Roth syndrome, a.k.a. meralgia paresthetica) and Ernst Julius Remak (son of Robert Remak). [worldneurologyonline.com]

On the classification, natural history and treatment of the myopathies. Brain. 1954. 77(2):169-231. [Medline]. Fanin M, Tasca E, Nascimbeni AC, et al. [emedicine.medscape.com]

Surgical treatment of an intramedullary haematoma simulating Wallenberg's syndrome. J Neurol Neurosurg Psychiatry 1964 ; 27 : 78 –80. 44. Neumann PE, Mehler MF, Horoupian DS. Primary medullary hypertensive hemorrhage. [cambridge.org]

Prognosis

Patients who require tracheostomy usually have guarded prognosis. [lecturio.com]

The clinical syndromes, vascular risk factor profile, presumed etiology of stroke, and prognosis allow consideration of small and large AChA territory infarcts in the differential diagnosis of patients with brain ischemia. [cambridge.org]

With the advancement of medical science, nowadays, early diagnosis and early initiation of treatment, and the use of rehabilitative services, medial medullary syndrome has a fair prognosis. [ncbi.nlm.nih.gov]

Etiology

Etiology These syndromes are classically caused by ischemic strokes that occur secondary to occlusion of small perforating arteries of the posterior circulation, however many have also been described secondary to hemorrhage, neoplasm, and demyelination [radiopaedia.org]

The high prevalence of arterial hypertension or diabetes mellitus as an isolated risk factor of stroke in small-sized AChA infarcts suggests that small artery disease is a common etiology of AChA territory infarcts. [cambridge.org]

Objectives: Outline the etiology of medial medullary syndrome. Describe the pathophysiology of medial medullary syndrome. Review the clinical features of medial medullary syndrome. [ncbi.nlm.nih.gov]

Pediatric Horner syndrome: etiologies and roles of imaging and urine studies to detect neuroblastoma and other responsible mass lesions.Am J Ophthalmol.2006;142(4):651-659. [ Links ] 32 - Koc F. [scielo.sa.cr]

Epidemiology

Epidemiology There are very few clinically and pathologically proven patients of medial medullary syndrome. Lateral medullary syndrome is relatively more common. [lecturio.com]

Dissection of the vertebral artery can also cause medial medullary syndrome, especially among young patients.[2][3][4] Epidemiology Stroke is the world's second-largest cause of death and a major cause of disability. [ncbi.nlm.nih.gov]

Pathophysiology

This clinical article discusses the pathophysiology of central neuropathic pain and its classification and differentiation from peripheral neuropathic pain. [medlink.com]

Describe the pathophysiology of medial medullary syndrome. Review the clinical features of medial medullary syndrome. [ncbi.nlm.nih.gov]

Prevention

[…] be started to prevent long-term complications. [ncbi.nlm.nih.gov]

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