Facial sensory symptoms in medullary infarcts.
OBJECTIVE
To investigate the correlation between facial sensory abnormalities and lesional topography in eight patients with lateral medullary infarcts (LMIs).


METHODS
We reviewed eight sequential cases of LMIs admitted to the Neurology Division of Hospital das Clínicas/São Paulo University between July, 2001 and August, 2002 except for one patient who had admitted in 1996 and was still followed in 2002. All patients were submitted to conventional brain MRI including axial T1-, T2-weighted and Fluid attenuated inversion-recovery (FLAIR) sequences. MRIs were evaluated blindly to clinical features to determine extension of the infarct to presumed topographies of the ventral trigeminothalamic (VTT), lateral spinothalamic, spinal trigeminal tracts and spinal trigeminal nucleus.


RESULTS
Sensory symptoms or signs were ipsilateral to the bulbar infarct in 3 patients, contralateral in 4 and bilateral in 1. In all of our cases with exclusive contralateral facial sensory symptoms, infarcts had medial extensions that included the VTT topography. In cases with exclusive ipsilateral facial sensory abnormalities, infarcts affected lateral and posterior bulbar portions, with slight or no medial extension. The only patient who presented bilateral facial symptoms had an infarct that covered both medial and lateral, in addition to the posterior region of the medulla.


CONCLUSIONS
Our results show a correlation between medial extension of LMIs and presence of contralateral facial sensory symptoms.
Conforto
Adriana Bastos
AB
Neurology Division, Hospital das Clínicas, São Paulo University, São Paulo, SP, Brazil. abconf@usp.br
Yamamoto
Fábio Iuji
FI
Leite
Cláudia da Costa
Cda C
Scaff
Milberto
M
Marie
Suely Kazue Nagahashi
SK
D000328:Adult; D001931:Brain Mapping; D005145:Face / Q000294:innervation / Q000503:physiopathology*; D005260:Female; D006801:Humans; D014854:Lateral Medullary Syndrome / Q000473:pathology* / Q000503:physiopathology; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D020886:Somatosensory Disorders / Q000503:physiopathology*