Bilateral medial medullary infarction with oculomotor disorders

Stroke. 1992 Nov;23(11):1657-9. doi: 10.1161/01.str.23.11.1657.

Abstract

Background and purpose: We describe the first case of bilateral medial medullary infarction demonstrated by magnetic resonance imaging. We discuss the relation between this lesion and the oculomotor signs that were observed clinically.

Case description: A 71-year-old man initially presented with pure motor hemiparesis, which progressed to complete quadriplegia. He also developed nearly complete vertical and horizontal ophthalmoplegia. Magnetic resonance imaging revealed upper medial medullary infarctions bilaterally that extended to the pontomedullary junction.

Conclusions: We propose that the vertical oculomotor disorders resulted from involvement of the oculomotor system in the caudal brain stem, especially the caudal paramedian pontine reticular formations on both sides.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cerebral Angiography
  • Cerebral Infarction / complications*
  • Cerebral Infarction / diagnosis
  • Cerebral Infarction / diagnostic imaging
  • Eye Movements
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Medulla Oblongata / blood supply*
  • Muscular Diseases / etiology
  • Oculomotor Muscles*
  • Ophthalmoplegia / etiology
  • Tomography, Emission-Computed, Single-Photon