World Library  
Flag as Inappropriate
Email this Article

Medial medullary syndrome

Article Id: WHEBN0000707605
Reproduction Date:

Title: Medial medullary syndrome  
Author: World Heritage Encyclopedia
Language: English
Subject: Lateral medullary syndrome, Lateral pontine syndrome, Anterior cerebral artery syndrome, Foville's syndrome, Millard–Gubler syndrome
Publisher: World Heritage Encyclopedia

Medial medullary syndrome

Medial medullary syndrome
Medulla oblongata, shown by a transverse section passing through the middle of the olive. (Medial medullary syndrome can affect structures in lower left: especially #5, #6, #8.)
Classification and external resources
ICD-10 G46.3
eMedicine emerg/834

Medial medullary syndrome, also known as inferior alternating syndrome, hypoglossal alternating hemiplegia, lower alternating hemiplegia,[1] or Dejerine syndrome,[2] is a type of alternating hemiplegia characterized by a set of clinical features resulting from occlusion of the anterior spinal artery. This results in the infarction of medial part of the medulla oblongata.


  • Pathophysiology 1
  • Presentation 2
  • See also 3
  • References 4
  • External links 5


The infarction leads to death of the ipsilateral medullary pyramid, the medial leminiscus, and the hypoglossal nerve fibers that pass through the medulla. The spinothalamic tract is spared because it is located more laterally in the brainstem and is not supplied by the anterior spinal artery, but rather by the vertebral and posterior inferior cerebellar arteries. The trigeminal nucleus is also spared, since most of it is higher up in the pons, and the spinal part of it found in the medulla is lateral to the infarct.


The condition usually consists of:

Description Source of damage Number on diagram
a deviation of the tongue to the side of the infarct on attempted protrusion, caused by ipsilateral muscle weakness. hypoglossal nerve fibers #8
limb weakness (or hemiplegia, depending on severity), on the contralateral side of the infarct medullary pyramid and hence to the corticospinal fibers of the pyramidal tract #5
a loss of discriminative touch, conscious proprioception, and vibration sense on the contralateral side of the infarct medial leminiscus #6
Human brainstem blood supply description. ASA is #13.

Sensation to the face is preserved, due to the sparing of the trigeminal nucleus.

The syndrome is said to be "alternating" because the lesion causes symptoms both contralaterally and ipsilaterally. Sensation of pain and temperature is preserved, because the spinothalamic tract is located more laterally in the brainstem and is also not supplied by the anterior spinal artery (instead supplied by the posterior inferior cerebellar arteries and the vertebral arteries).

See also


  1. ^ "Atlas of Microscopic Anatomy: Section 17 - Central Nervous System. Plate 17.330 Medulla Oblongata". Retrieved 2007-06-07. 
  2. ^ Yokota J, Amakusa Y, Tomita Y, Takahashi S (February 2003). "[The medial medullary infarction (Dejerine syndrome) following chiropractic neck manipulation]". No To Shinkei (in Japanese) 55 (2): 121–5.  

External links

This article was sourced from Creative Commons Attribution-ShareAlike License; additional terms may apply. World Heritage Encyclopedia content is assembled from numerous content providers, Open Access Publishing, and in compliance with The Fair Access to Science and Technology Research Act (FASTR), Wikimedia Foundation, Inc., Public Library of Science, The Encyclopedia of Life, Open Book Publishers (OBP), PubMed, U.S. National Library of Medicine, National Center for Biotechnology Information, U.S. National Library of Medicine, National Institutes of Health (NIH), U.S. Department of Health & Human Services, and, which sources content from all federal, state, local, tribal, and territorial government publication portals (.gov, .mil, .edu). Funding for and content contributors is made possible from the U.S. Congress, E-Government Act of 2002.
Crowd sourced content that is contributed to World Heritage Encyclopedia is peer reviewed and edited by our editorial staff to ensure quality scholarly research articles.
By using this site, you agree to the Terms of Use and Privacy Policy. World Heritage Encyclopedia™ is a registered trademark of the World Public Library Association, a non-profit organization.

Copyright © World Library Foundation. All rights reserved. eBooks from World Library are sponsored by the World Library Foundation,
a 501c(4) Member's Support Non-Profit Organization, and is NOT affiliated with any governmental agency or department.