Medial Medullary Syndrome (Dejerine Syndrome)

Eponym

Dejerine Syndrome

Anatomy

Medulla: Medial medulla

Vascular

  • Vertebral artery: Anteromedial artery
  • Anterior spinal artery: Anteromedial artery
  • Basilar artery

Signs & Symptoms

Side Manifestation Comments
Contralateral Weakness – upper and lower extremity Pyramidal tract
Contralateral Hemisensory loss – vibration and proprioception Medial lemniscus
Ipsilateral Tongue weakness +/- atrophy Cn 12 nucleus

Notes

Rare stroke syndrome (<1% of vertebrobasilar strokes, Bassetti et al., 1994). Medial medullary infarct is associated with clinical triad of ipsilateral hypoglossal palsy, contralateral hemiparesis, and contralateral lemniscal sensory loss. Variable manifestations may include isolated hemiparesis, tetraparesis, ipsilateral hemiparesis, I or C facial palsy, ataxia, vertigo, nystagmus, dysphagia. Palatal and pharyngeal weakness rare in pure MMI, common in lateral medullary infarct.

References