Lee S H, Kim D E, Song E C, Roh J K
Department of Neurology, Seoul National University Hospital, 28 Yongon-dong, Chongno-gu, Seoul 110-744, Korea.
Arch Neurol. 2001 Apr;58(4):649-51. doi: 10.1001/archneur.58.4.649.
Restricted sensory deficits along the somatotopic topography of the medial lemniscus rarely develop in medial medullary infarction. We describe a patient with medial medullary infarction who presented with dermatomal sensory deficits caused by a medial lemniscal lesion.
A 58-year-old man presented with sudden right-sided hemiparesis and paresthesia. He had noticed the paresthesia below the level of the right L5 dermatome, where his vibration and position senses were mildly diminished. His paresthesia was more severe over the right calf and foot. Magnetic resonance images of the brain showed an acute small infarct in the medial-ventral portion of the left rostral medulla oblongata. A nerve conduction study and electromyography showed no abnormalities. At follow-up, the patient's motor and sensory deficits had improved considerably.
The patient showed lemniscal sensory deficits below the right L5 dermatome that were caused by the partial involvement of the medial lemniscus. These findings suggest that lemniscal sensory dermatomal representation is preserved at least up to the level of the medulla oblongata.
在内侧延髓梗死中，沿内侧丘系躯体感觉定位分布的局限性感觉缺失很少发生。我们描述了一名患有内侧延髓梗死的患者，该患者因内侧丘系病变出现了皮节性感觉缺失。
一名58岁男性，突发右侧偏瘫和感觉异常。他注意到右侧L5皮节水平以下有感觉异常，其振动觉和位置觉轻度减退。他的右侧小腿和足部感觉异常更为严重。脑部磁共振成像显示左侧延髓头端内侧腹侧有一个急性小梗死灶。神经传导研究和肌电图检查未发现异常。随访时，患者的运动和感觉缺失有明显改善。
该患者右侧L5皮节以下出现了内侧丘系部分受累所致的感觉缺失。这些发现表明，内侧丘系的感觉皮节代表至少在延髓水平得以保留。
