Abstract :
Context: Lateral medullary infarction is typically associated with loss of pain and temperature over ipsilateral face and contralateral body. However, sensory loss in contralateral face and body has been described in lateral medullary syndrome- the pseudothalamic pattern or type IV sensory loss of Stopford classification.
Aims: This article aims at identifying lateral medullary syndromes associated with sensory impairment over contralateral face and body, and reviewing the neuroanatomical substrate leading to the same.
Settings and Design: This was a prospective study conducted at Department of Neurology, at a tertiary level teaching hospital, Kerala, India, over a period of 5 years, among patients with acute ischemic stroke.
Methods and Material: We studied all patients with acute ischemic stroke, who were admitted to our department, over a five-year period. Patients presenting with lateral medullary syndrome, with a pseudothalamic pattern of sensory loss were shortlisted and were assessed by investigators independently. All patients underwent MRI brain, which was assessed by investigators 1 and 2, independently. The demographic profile, risk factors, clinical features, neuroimaging findings and outcomes were analysed.
Results: A total of 1492 patients with acute ischemic strokes were identified, of which 6 with lateral medullary syndrome with a pseudothalamic pattern of sensory loss were included in the study. Of the 6 patients, two had central post stroke pain, which was refractory to treatment.
Conclusions: The type IV sensory loss of Stopford classification or the pseudothalamic pattern of sensory loss is a less described pattern in lateral medullary syndrome. The central post stroke pain (CPSP) which may develop in these patients is difficult to treat.
Keyword :
Pseudothalamic pattern, Stopford classification, Lateral medullary syndrome, Central post.