Recurrent Lateral Medullary Infarction with Ipsilateral Motor and Sensory Deficits and a Delayed Worsening of Crossed Hypoalgesia and Thermohypoesthesia: A Case Report
Year: 2026
Type: article
Study design: Case Report
Abstract: The clinical course of early recurrent lateral medullary infarction (LMI) is unclear. We describe the case of an 83-year-old man with severe vertebral artery atherosclerosis who developed early recurrent right LMI. He had ipsilateral Horner's syndrome, bulbar symptoms, and ipsilateral motor-sensory deficits (an Opalski syndrome-like presentation). Imaging revealed caudal extension of the lesion toward the paramedian cervicomedullary junction. A gradual improvement was observed with dual antiplatelet therapy and argatroban hydrate. Contralateral hypoalgesia and thermohypoesthesia were initially minimal, became prominent after 1 week, and later improved spontaneously. Delayed sensory changes during recurrent LMI may complicate the clinical interpretation, warranting careful serial neurological and radiological assessments.
Source: Internal Medicine
Authors: Yujiro Yoshioka, Takahide Nagashima, Jun Goto
Institutions: Keio University, Ashikaga Red Cross Hospital
Language: English
Subfield: Clinical Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7213956201