What are the signs and symptoms of medial medullary syndrome in vertebrobasilar stroke?

Updated: Aug 09, 2021
  • Author: Vladimir Kaye, MD; Chief Editor: Stephen Kishner, MD, MHA  more...
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This syndrome is an uncommon lesion resulting from occlusion of a vertebral artery or its branch to the anterior spinal artery; it involves the pyramid, the medial lemniscus, and, sometimes, the hypoglossal nerve.

The clinical features include ipsilateral paresis of the tongue with deviation toward the lesion (lower motor neuron lesion of CN XII), contralateral hemiplegia with sparing of the face (corticospinal tract), and loss of ipsilateral vibration and proprioception (medial lemniscus). (See the image below.)

LMN Lesion of the hypoglossal nerve producing tong LMN Lesion of the hypoglossal nerve producing tongue deviation to the side of the lesion. (Courtesy of BC Decker Inc.)

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