Lateral medullary infarction presenting as Brown-Séquard syndrome-like manifestation: a case report and literature review.

Abstract

Lateral medullary infarction is not uncommon in clinical practice of neurology. This report describes a patient who initially presented with Brown-Séquard syndrome-like manifestation but was later diagnosed with acute infarction in the left lower lateral medulla. A 65-year-old woman presented with acute onset of unsteadiness, left side hemiparesis, left limb dysmetria, left side partial Horner syndrome, and paresthesia in the right lower limb and trunk with a sensory level at T5 on the right. No bulbar symptoms nor facial paresthesia was noted. Brown- Séquard syndrome was suspected initially, but cervical spine magnetic resonance imaging showed only mild spinal stenosis. Brain magnetic resonance imaging revealed acute infarction in the left lower lateral medulla. The mechanism of this unusual presentation is discussed. Brown-Séquard syndrome-like manifestation can be a rare presentation of lower lateral medullary infarction.