Department of Neurology and Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Department of Geriatrics and Gerontology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Neurol Sci. 2022 Nov;43(11):6555-6559. doi: 10.1007/s10072-022-06306-2. Epub 2022 Aug 4.
Lateral medullary syndrome (LMS) is an ischemic stroke of the medulla oblongata that involves the territory of the posterior inferior cerebellar artery. LMS is often missed as the cause of autonomic dysregulation in patients with recent brain stem stroke. Due to the location of the nucleus tractus solitarius (NTS), the dorsal vagal nucleus, and the nucleus ambiguous in the lateral medulla oblongata, patients with LMS occasionally have autonomic dysregulation-associated clinical manifestations. We report a case of LMS-associated autonomic dysregulation. The case presented by recurrent syncope, requiring permanent pacemaker placement. This case shows the importance of recognizing LMS as a potential cause of life-threatening arrhythmias, heart block, and symptomatic bradycardia. Extended cardiac monitoring should be considered for patients with medullary strokes.
延髓外侧综合征（LMS）是一种累及小脑后下动脉供血区的延髓缺血性卒中。LMS 常被漏诊为近期脑干卒中患者自主神经功能紊乱的病因。由于孤束核、迷走神经背核和疑核位于延髓外侧，LMS 患者偶尔会出现自主神经功能紊乱相关的临床表现。我们报告一例 LMS 相关的自主神经功能紊乱。该病例表现为反复发作性晕厥，需要永久性起搏器植入。该病例表明，认识到 LMS 是危及生命的心律失常、心脏传导阻滞和症状性心动过缓的潜在病因的重要性。应考虑对延髓卒中患者进行延长的心脏监测。
