MRCP PACES Brainstem Syndromes Medullary Syndromes
  • Medial medullary syndrome (Dejerine’s syndrome – distal vertebral artery / proximal anterior spinal artery)
    • Spares face
    • Ipsilateral tongue weakness (tongue deviates towards side of lesion)
    • Contralateral hemiparesis (may be variable depending on location of lesion in relation to decussating corticospinal tract fibres)
    • Contralateral loss of vibration / proprioception
    • Pain and temperature from limbs not affected
  • Lateral medullary syndrome (Wallenberg’s syndrome – vertebral artery / posterior inferior cerebellar artery)
    • Ipsilateral ataxia (spinocerebellar tract and inferior cerebellar peduncle)
    • Ipsilateral loss of pain and temperature sensation in face (spinothalamic tract of trigeminal nerve)
    • Contralateral loss of pain and temperature sensation from limbs (spinothalamic tract)
    • Ipsilateral Horner’s syndrome (sympathetic fibres)
    • Ipsilateral reduced gag reflex (vagus nerve)
    • Dysphagia, dysarthria (bulbar palsy)
Previous Topic
Back to Section
Next Section