Abstract
Background: Various sensory impairments have been reported in patients with lateral medullary syndrome, also known as Wallenberg syndrome. The typical sensory impairments experienced by patients with this condition are ipsilateral facial and contralateral trunk and limb thermal hypesthesia and hypoalgesia. Tactile (light touch) sensation is not generally diminished. Here we report the case of a 35-year-old man with lateral medullary infarction who had atypical sensory impairment. Methods: We examined the results from the neurological examination of the patient as well as findings from computed tomography of the head and magnetic resonance imaging. Results: Magnetic resonance imaging showed left lateral medullary infarction caused by left posterior inferior cerebellar artery dissection. Neurological examination revealed both tactile and thermal/pain hypesthesia on the left side of the patient's face, and thermal/pain hypesthesia on his right upper and lower limbs. Conclusion: There are two types of tactile sensation: epicritic and protopathic. Facial tactile sensation is usually thought to be associated with epicritic tactile sensation, which travels through principal sensory nuclei of the trigeminal nerve. The protopathic pathway travels down through the spinal tract via the trigeminal nerve and is not considered a primary pathway. However, in this case the protopathic tactile sensation pathway might be involved, and it caused facial tactile hypesthesia. Because most of previous case reports and literature reviews focused only on thermal/pain hypesthesia, we believe that this case provides critical information on the brainstem neuroanatomy, especially for the protopathic tactile sensation pathway in patients with stroke.
| Original language | English |
|---|---|
| Pages (from-to) | e315-e317 |
| Journal | Journal of Stroke and Cerebrovascular Diseases |
| Volume | 24 |
| Issue number | 11 |
| DOIs | |
| Publication status | Published - 2015 Nov 1 |
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Keywords
- ipsilateral face
- Lateral medullary infarction
- tactile hypesthesia
- Wallenberg syndrome
ASJC Scopus subject areas
- Clinical Neurology
- Surgery
- Rehabilitation
- Cardiology and Cardiovascular Medicine
Cite this
Ipsilateral Facial Tactile Hypesthesia in a Patient with Lateral Medullary Syndrome. / Katsumata, Masahiro; Oki, Koichi; Nakahara, Jin; Izawa, Yoshikane; Abe, Takato; Takahashi, Shinichi; Suzuki, Norihiro.
In: Journal of Stroke and Cerebrovascular Diseases, Vol. 24, No. 11, 01.11.2015, p. e315-e317.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Ipsilateral Facial Tactile Hypesthesia in a Patient with Lateral Medullary Syndrome
AU - Katsumata, Masahiro
AU - Oki, Koichi
AU - Nakahara, Jin
AU - Izawa, Yoshikane
AU - Abe, Takato
AU - Takahashi, Shinichi
AU - Suzuki, Norihiro
PY - 2015/11/1
Y1 - 2015/11/1
N2 - Background: Various sensory impairments have been reported in patients with lateral medullary syndrome, also known as Wallenberg syndrome. The typical sensory impairments experienced by patients with this condition are ipsilateral facial and contralateral trunk and limb thermal hypesthesia and hypoalgesia. Tactile (light touch) sensation is not generally diminished. Here we report the case of a 35-year-old man with lateral medullary infarction who had atypical sensory impairment. Methods: We examined the results from the neurological examination of the patient as well as findings from computed tomography of the head and magnetic resonance imaging. Results: Magnetic resonance imaging showed left lateral medullary infarction caused by left posterior inferior cerebellar artery dissection. Neurological examination revealed both tactile and thermal/pain hypesthesia on the left side of the patient's face, and thermal/pain hypesthesia on his right upper and lower limbs. Conclusion: There are two types of tactile sensation: epicritic and protopathic. Facial tactile sensation is usually thought to be associated with epicritic tactile sensation, which travels through principal sensory nuclei of the trigeminal nerve. The protopathic pathway travels down through the spinal tract via the trigeminal nerve and is not considered a primary pathway. However, in this case the protopathic tactile sensation pathway might be involved, and it caused facial tactile hypesthesia. Because most of previous case reports and literature reviews focused only on thermal/pain hypesthesia, we believe that this case provides critical information on the brainstem neuroanatomy, especially for the protopathic tactile sensation pathway in patients with stroke.
AB - Background: Various sensory impairments have been reported in patients with lateral medullary syndrome, also known as Wallenberg syndrome. The typical sensory impairments experienced by patients with this condition are ipsilateral facial and contralateral trunk and limb thermal hypesthesia and hypoalgesia. Tactile (light touch) sensation is not generally diminished. Here we report the case of a 35-year-old man with lateral medullary infarction who had atypical sensory impairment. Methods: We examined the results from the neurological examination of the patient as well as findings from computed tomography of the head and magnetic resonance imaging. Results: Magnetic resonance imaging showed left lateral medullary infarction caused by left posterior inferior cerebellar artery dissection. Neurological examination revealed both tactile and thermal/pain hypesthesia on the left side of the patient's face, and thermal/pain hypesthesia on his right upper and lower limbs. Conclusion: There are two types of tactile sensation: epicritic and protopathic. Facial tactile sensation is usually thought to be associated with epicritic tactile sensation, which travels through principal sensory nuclei of the trigeminal nerve. The protopathic pathway travels down through the spinal tract via the trigeminal nerve and is not considered a primary pathway. However, in this case the protopathic tactile sensation pathway might be involved, and it caused facial tactile hypesthesia. Because most of previous case reports and literature reviews focused only on thermal/pain hypesthesia, we believe that this case provides critical information on the brainstem neuroanatomy, especially for the protopathic tactile sensation pathway in patients with stroke.
KW - ipsilateral face
KW - Lateral medullary infarction
KW - tactile hypesthesia
KW - Wallenberg syndrome
UR - http://www.scopus.com/inward/record.url?scp=84946475471&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84946475471&partnerID=8YFLogxK
U2 - 10.1016/j.jstrokecerebrovasdis.2015.07.027
DO - 10.1016/j.jstrokecerebrovasdis.2015.07.027
M3 - Article
VL - 24
SP - e315-e317
JO - Journal of Stroke and Cerebrovascular Diseases
JF - Journal of Stroke and Cerebrovascular Diseases
SN - 1052-3057
IS - 11
ER -