Medial Medullary Syndrome

Medial Medullary Syndrome

The medial medullary syndrome, or Dejerine’s anterior bulbar syndrome, results from damage to the medial medulla, most usually infarction as a consequence of anterior spinal artery or vertebral artery occlusion. The clinical picture is of:

• Ipsilateral tongue paresis and atrophy, fasciculations (hypoglossal nerve involvement)
• Contralateral hemiplegia with sparing of the face (pyramid)
• Contralateral loss of position and vibration sense (medial lemnis- cus) with pain and temperature sensation spared
• +/− upbeat nystagmus (?nucleus intercalatus of Staderini).

References

Hirose G, Ogasawara T, Shirakawa T, et al. Primary position upbeat nystagmus due to unilateral medial medullary infarction. Annals ofNeurology 1998; 43: 403-406
Sawada H, Seriu N, Udaka F, Kameyama M. Magnetic resonance imaging of medial medullary infarction. Stroke 1990; 21: 963-966 Cross

References
Fasciculation; Hemiplegia; Lateral medullary syndrome; Nystagmus