Recurrent Lateral Medullary Infarction with Ipsilateral Motor and Sensory Deficits and a Delayed Worsening of Crossed Hypoalgesia and Thermohypoesthesia: A Case Report
Abstract
The clinical course of early recurrent lateral medullary infarction (LMI) is unclear. We describe the case of an 83-year-old man with severe vertebral artery atherosclerosis who developed early recurrent right LMI. He had ipsilateral Horner's syndrome, bulbar symptoms, and ipsilateral motor-sensory deficits (an Opalski syndrome-like presentation). Imaging revealed caudal extension of the lesion toward the paramedian cervicomedullary junction. A gradual improvement was observed with dual antiplatelet therapy and argatroban hydrate. Contralateral hypoalgesia and thermohypoesthesia were initially minimal, became prominent after 1 week, and later improved spontaneously. Delayed sensory changes during recurrent LMI may complicate the clinical interpretation, warranting careful serial neurological and radiological assessments.
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BibTeX
@article{yoshioka2026recurrent,
title = {{Recurrent Lateral Medullary Infarction with Ipsilateral Motor and Sensory Deficits and a Delayed Worsening of Crossed Hypoalgesia and Thermohypoesthesia: A Case Report}},
author = {Yujiro Yoshioka and Takahide Nagashima and Jun Goto},
journal = {Internal Medicine},
year = {2026},
month = sep,
doi = {10.2169/internalmedicine.7522-26},
url = {https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7522-26/_article},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Recurrent Lateral Medullary Infarction with Ipsilateral Motor and Sensory Deficits and a Delayed Worsening of Crossed Hypoalgesia and Thermohypoesthesia: A Case Report
AU - Yujiro Yoshioka
AU - Takahide Nagashima
AU - Jun Goto
PY - 2026
DA - 2026/09/22
JO - Internal Medicine
DO - 10.2169/internalmedicine.7522-26
UR - https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7522-26/_article
AB - The clinical course of early recurrent lateral medullary infarction (LMI) is unclear. We describe the case of an 83-year-old man with severe vertebral artery atherosclerosis who developed early recurrent right LMI. He had ipsilateral Horner's syndrome, bulbar symptoms, and ipsilateral motor-sensory deficits (an Opalski syndrome-like presentation). Imaging revealed caudal extension of the lesion toward the paramedian cervicomedullary junction. A gradual improvement was observed with dual antiplatelet therapy and argatroban hydrate. Contralateral hypoalgesia and thermohypoesthesia were initially minimal, became prominent after 1 week, and later improved spontaneously. Delayed sensory changes during recurrent LMI may complicate the clinical interpretation, warranting careful serial neurological and radiological assessments.
SN - 1349-7235
SN - 0918-2918
ER -