Gastroenterology and Hepatology Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran.
Faculty of Medicine, Kerman University of medical sciences, Kerman, Iran.
Clin Neurol Neurosurg. 2024 Oct;245:108474. doi: 10.1016/j.clineuro.2024.108474. Epub 2024 Jul 31.
Opalski syndrome, a subtype of lateral medullary syndrome (LMS), poses challenges due to its diverse clinical presentations and potential atypical symptoms. Understanding its epidemiology, clinical manifestations, and outcomes is crucial for optimizing patient care.
A systematic review, following PRISMA 2020 guidelines, was conducted to comprehensively analyze Opalski syndrome. Data from PubMed, Scopus, Web of Science, and Embase were included, with the search conducted in May 2023. Eligible studies spanned from included case reports, case series, and editorial letters.
In the final analysis of 80 studies from 1984 to 2024, a total of 96 patients were evaluated. The analysis revealed a male predominance (76.60 %) with a male-to-female ratio of 3.1:1. Common risk factors included hypertension (63.54 %), diabetes mellitus (32.29 %), smoking (32.39 %), and alcohol consumption (22.91 %). Opalski syndrome cases were reported in 22 countries across 5 continents, with Asia being the most prevalent region (77.08 %). Initial presentations commonly included ataxia or positive finger-to-nose and knee-to-heel tests, dizziness or vertigo, hemiparesis, nystagmus, Horner's sign, and 5th or 7th cranial nerve palsy, all occurring in more than 50 % of cases. Neuroimaging techniques such as magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) were crucial for diagnosis. Despite a mortality rate of 4.16 %, no deaths have been reported since 2014, indicating advancements in clinical management.
Targeted risk factor management, early recognition of symptoms, and utilization of advanced neuroimaging techniques are essential for optimizing patient outcomes. Clinicians must remain informed about Opalski syndrome to enhance diagnostic accuracy and tailor treatment strategies.
Opalski 综合征是外侧延髓综合征（LMS）的一个亚型，由于其临床表现多样且可能出现非典型症状，因此具有挑战性。了解其流行病学、临床表现和结局对于优化患者治疗至关重要。
我们按照 PRISMA 2020 指南进行了系统评价，全面分析了 Opalski 综合征。我们纳入了来自 PubMed、Scopus、Web of Science 和 Embase 的数据，检索时间截至 2023 年 5 月。纳入的研究包括病例报告、病例系列和社论信件。
在对 1984 年至 2024 年的 80 项研究进行最终分析后，共评估了 96 例患者。分析结果显示，男性居多（76.60%），男女比例为 3.1:1。常见的危险因素包括高血压（63.54%）、糖尿病（32.29%）、吸烟（32.39%）和饮酒（22.91%）。Opalski 综合征病例报告分布在 5 大洲的 22 个国家，亚洲是最常见的地区（77.08%）。最初的表现通常包括共济失调或指鼻试验和跟膝试验阳性、头晕或眩晕、偏瘫、眼球震颤、Horner 征和第 5 或第 7 颅神经麻痹，这些症状均在超过 50%的病例中出现。磁共振成像（MRI）和磁共振血管造影（MRA）等神经影像学技术对于诊断至关重要。尽管死亡率为 4.16%，但自 2014 年以来没有死亡报告，这表明临床管理取得了进展。
有针对性的危险因素管理、早期识别症状以及利用先进的神经影像学技术对于优化患者结局至关重要。临床医生必须了解 Opalski 综合征，以提高诊断准确性并制定治疗策略。
