51. Paroxysmal sneezing at the onset of lateral medullary syndrome: cause or consequence?
- Author
-
Enrique C. Leira and Andrea Swenson
- Subjects
Male ,medicine.medical_specialty ,Medullary cavity ,Vertebral artery dissection ,Ischemia ,Dissection (medical) ,Sneezing ,Internal medicine ,Humans ,Medicine ,Pathological ,Lateral Medullary Syndrome ,Aged, 80 and over ,Neck pain ,Lateral medullary syndrome ,business.industry ,Middle Aged ,medicine.disease ,Paroxysmal sneezing ,Magnetic Resonance Imaging ,Surgery ,Neurology ,Cardiology ,Neurology (clinical) ,medicine.symptom ,Tomography, X-Ray Computed ,business ,Magnetic Resonance Angiography - Abstract
Sneezing is known to precede lateral medullary syndrome (LMS). It is usually interpreted as the precipitating cause for a vertebral artery dissection that subsequently causes LMS. Through two case reports and a literature review, we aim to challenge the concept that sneezing at the onset of LMS implies that a dissection is the underlying cause. An 82-year-old man and a 54-year-old man both reported unprovoked explosive pathological sneezing at the onset of the LMS without any delay between sneezing and the other LMS symptoms. Both denied neck trauma or neck pain. There was no conclusive evidence for vertebral artery dissection in either case. Paroxysmal sneezing can be an initial manifestation of lateral medullary ischemia and may not necessarily indicate an underlying vertebral artery dissection as the cause.
- Published
- 2007