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Medial Medullary Syndrome

Learning objectives

  • Learning
  • Understand
  • Integrate
  • Reflect

  • Dejerine syndrome
  • Rare less than 1% of brainstem strokes

  • Thrombotic or embolic occlusion of small perforating branches from vertebral or proximal basilar artery supplying the medial aspect of medulla oblongata
  • C/L hemiplegia/hemiparesis
  • C/L hemisensory loss
  • Ipsilateral hypoglossal palsy (tongue weak)
  • Vertigo, nausea, or contralateral limb ataxia are also reported
  • Bloods: FBC/U&E/ESR/CRP/Glucose, lipids
  • ECG/Holter/Echo: Look for AF or evidence for AF
  • MRI DWI should be diagnostic
  • Aspirin 300 mg 2 weeks then Clopidogrel 75 mg od
  • PEG early for severe dysphagia which can often be removed at 6 weeks
  • Assess particularly for embolic stroke causes
  • Standard ischaemic stroke management and Neurorehabilitation