Alterations of sensory levels in vascular lesions of lateral medulla.

Abstract

DEFECTS in pain and temperature sensibilities at and below a level over the trunk are usually signs of spinal cord disease; however, levels may also appear in patients with disease of the brain stem, especially the lateral medulla. Occasionally, such a sensory deficit may give the impression that multiple lesions are present. For example, a patient with a right facial palsy later developed a level lesion for pain and temperature at T-6 on the left side; multiple lesions were suspected (multiple sclerosis), but at subsequent autopsy there was but one lesion, a glioma of the brain stem (pons and medulla). Thereafter, we searched for patients with clinical evidence of acute sensory dysfunctions due to lesions of the lateral medulla (vascular insults) and performed detailed serial examinations of the resultant sensory defects over the body and face. Search of the literature uncovered many clinical and clinicopathologic reports of patients