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[Ipsilateral central-type facial palsy and contralateral hemiparesis associated with unilateral medial medullary infarction: a case report].
Rinsho Shinkeigaku. 1998 Aug; 38(8):750-3.RS

Abstract

Clinical pictures of medial medullary syndrome are variable, depending upon the extent of the lesion. Facial palsy has rarely been observed even in medullary infarction. However, central-type facial palsy is usually found contralaterally to the infarct area at the level of the rostral medulla. In the present report, we discuss the pathogenesis of the neurological manifestations in a 57-year-old man with hypertension. The patient presented with mild left facial palsy of central type, right hemiparesis, paresthesia, with deep sensory disturbance of the right extremities. An MRI of the brain showed an infarction localized in the medial region of the left upper medulla. Although the exact course of the supranuclear facial pathways remains controversial, the ipsilateral central facial palsy in this patient is considered to have two possible causes: the interruption of aberrant fibers of the corticobulbar tract, which branch off and swing back at the level of the upper-middle medulla, or the disruption of recurrent ascending fibers from the contralateral pyramidal tract, through decussation.

Authors+Show Affiliations

Department of Neurology, Higasi Municipal Hospital of Nagoya, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
English Abstract
Journal Article

Language

jpn

PubMed ID

9916522

Citation

Yamana, T, et al. "[Ipsilateral Central-type Facial Palsy and Contralateral Hemiparesis Associated With Unilateral Medial Medullary Infarction: a Case Report]." Rinsho Shinkeigaku = Clinical Neurology, vol. 38, no. 8, 1998, pp. 750-3.
Yamana T, Hasegawa Y, Dei R, et al. [Ipsilateral central-type facial palsy and contralateral hemiparesis associated with unilateral medial medullary infarction: a case report]. Rinsho Shinkeigaku. 1998;38(8):750-3.
Yamana, T., Hasegawa, Y., Dei, R., Saitou, Y., & Takagi, S. (1998). [Ipsilateral central-type facial palsy and contralateral hemiparesis associated with unilateral medial medullary infarction: a case report]. Rinsho Shinkeigaku = Clinical Neurology, 38(8), 750-3.
Yamana T, et al. [Ipsilateral Central-type Facial Palsy and Contralateral Hemiparesis Associated With Unilateral Medial Medullary Infarction: a Case Report]. Rinsho Shinkeigaku. 1998;38(8):750-3. PubMed PMID: 9916522.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Ipsilateral central-type facial palsy and contralateral hemiparesis associated with unilateral medial medullary infarction: a case report]. AU - Yamana,T, AU - Hasegawa,Y, AU - Dei,R, AU - Saitou,Y, AU - Takagi,S, PY - 1999/1/23/pubmed PY - 1999/1/23/medline PY - 1999/1/23/entrez SP - 750 EP - 3 JF - Rinsho shinkeigaku = Clinical neurology JO - Rinsho Shinkeigaku VL - 38 IS - 8 N2 - Clinical pictures of medial medullary syndrome are variable, depending upon the extent of the lesion. Facial palsy has rarely been observed even in medullary infarction. However, central-type facial palsy is usually found contralaterally to the infarct area at the level of the rostral medulla. In the present report, we discuss the pathogenesis of the neurological manifestations in a 57-year-old man with hypertension. The patient presented with mild left facial palsy of central type, right hemiparesis, paresthesia, with deep sensory disturbance of the right extremities. An MRI of the brain showed an infarction localized in the medial region of the left upper medulla. Although the exact course of the supranuclear facial pathways remains controversial, the ipsilateral central facial palsy in this patient is considered to have two possible causes: the interruption of aberrant fibers of the corticobulbar tract, which branch off and swing back at the level of the upper-middle medulla, or the disruption of recurrent ascending fibers from the contralateral pyramidal tract, through decussation. SN - 0009-918X UR - https://www.unboundmedicine.com/medline/citation/9916522/[Ipsilateral_central_type_facial_palsy_and_contralateral_hemiparesis_associated_with_unilateral_medial_medullary_infarction:_a_case_report]_ DB - PRIME DP - Unbound Medicine ER -