Clinical profile and sensory pattern in lateral medullary syndrome
DOI:
https://doi.org/10.18203/2349-3933.ijam20232824Keywords:
Lateral medullary syndrome, Stroke, Sensory loss, Dysphagia, UnsteadinessAbstract
Background: Lateral Medullary syndrome is an acute ischemic stroke syndrome characterised by occlusion of the vertebral artery/posterior inferior cerebellar artery. The study aimed to describe the sensory pattern and clinical profile of patients admitted with lateral medullary syndrome.
Methods: This cross-sectional descriptive study was done in the neurology department at Thanjavur Government Medical College, Tamil Nadu. Twenty patients with acute stroke clinically suspected of lateral medullary syndrome were taken into this study for one year. Magnetic Resonance Imaging (MRI) of the brain with an MR Angiogram was done to confirm clinical suspicion of Lateral medullary syndrome. They were examined in detail for clinical profile and sensory pattern, and relevant investigations were done.
Results: Among the 20 LMS patients, 85% were males, and the mean age of occurrence was 53.2 years. All of them had acute infarcts in the lateral medulla. Hypertension, diabetes mellitus and dyslipidemia were the most common systemic risk factors. The most common sensory pattern observed was classical, with loss of sensation in the ipsilateral face and contralateral body in 45% of patients. The most common clinical presentation was walking instability, bulbar symptoms, and a longer hospital stay. The second most common pattern was only sensory impairment in the ipsilateral face, seen in 30%. Their clinical presentation was unsteadiness while walking, with no bulbar symptoms, shorter hospital stays, and better recovery.
Conclusions: LMS is an acute stroke syndrome common in males, often after 50 years, with hypertension, diabetes, and dyslipidemia as systemic risk factors.
References
Kim H, Lee HJ, Park JW. Clinical course and outcome in patients with severe dysphagia after lateral medullary syndrome. Ther Adv Neurol Disord. 2018;11:175.
Thapliyal K, Garg A, Singh VP. Lateral medullary syndrome: Case report and review of the literature. J Family Med Prim Care. 2022;11:7438-41.
Kim JS, Lee JH, Lee MC. Patterns of sensory dysfunction in lateral medullary infarction: Clinical-MRI correlation. Neurology 1997;49:1557-63.
Paul W Brazis, Joseph CM, Jose B. Localization in clinical neurology. Brainstem. 2021;5:552-3.
Day GS, Swartz RH, Chenkin J, Shamji AI, Frost DW. Lateral medullary syndrome: a diagnostic approach illustrated through case presentation and literature review. CJEM. 2014;16:164-70.
Shrestha R, Pandit R, Acharya A, Kharel G, Maharjan AS, Phuyal S, et al. Clinico-radiological profile of patients with lateral medullary syndrome: A five years observation from a single-centred tertiary hospital in Nepal. Cureus 2022;14:e28834.
Thahseen NS, Saravanan S, Sankaranarayanan P. Clinical profile of lateral medullary syndrome in a tertiary care hospital in South Tamilnadu. Int J Sci Res. 2023;12:24-6.
Fukuoka T, Takeda H, Dembo T, Nagoya H, Kato Y, Deguchi I, et al. Clinical review of 37 patients with medullary infarction. J Stroke Cerebrovasc Dis. 2012;21:594-9.
Sacco RL, Freddo L, Bello JA, Odel JG, Onesti ST, Mohr JP. Wallenberg's lateral medullary syndrome. clinical-magnetic resonance imaging correlations. Arch Neurol. 1993;50:609-14.
Sheetal S, Thomas R. Pseudothalamic pattern of sensory loss in lateral medullary syndrome-A clinico anatomic correlation. IP Indian J Neurosci. 2020;6: 272-5.
