J Clin Neurol.  2007 Jun;3(2):112-115. 10.3988/jcn.2007.3.2.112.

Pure Sensory Deficit at the T4 Sensory Level as an Isolated Manifestation of Lateral Medullary Infarction

• Song IU
• Kim JS
• Lee DG
• An JY
• Ryu SY
• Lee SB
• Kim YI
• Lee KS

• KMID: 1851024
• DOI: http://doi.org/10.3988/jcn.2007.3.2.112

Abstract

In rare cases restricted sensory deficits along the somatotopic topography of the spinothalamic tract can develop from a lateral medullary infarction. To our knowledge, isolated dermatomal sensory deficit as a single manifestation of a lateral medullary infarction has not been reported previously. A 58-year-old man presenting with sudden left-sided paresthesia complained of sensory deficit of pain and temperature below the left T4 sensory level without other neurologic deficits. Diffuse- and T2-weighted magnetic resonance imaging (MRI) of the brain showed high signal intensities in the right lower medulla oblongata, whereas thoracic-spine MRI and somatosensory evoked potentials produced normal findings.

Keyword

Somatotopic topography; Lateral medullary infarction

MeSH Terms

Brain
Evoked Potentials, Somatosensory
Humans
Infarction*
Magnetic Resonance Imaging
Medulla Oblongata
Middle Aged
Neurologic Manifestations
Paresthesia
Spinothalamic Tracts

Figure

• 

  Figure 1 Diffusion- and T2-weighted MRI of the brain revealed a small lesion with a high signal intensity in the right lateral medulla (arrows) consistent with acute infarction.

• 

  Figure 2 Sensory topography of the spinothalamic tract in the patient. The gray area indicates the presumed location of the lesion in the lower medulla oblongata.

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