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Topographic Consideration on the Occurrence of Ipsilesional Facial Paresis in Lateral Medullary Infarction.

Authors :
Kim YK
Kim YB
Suh BC
Jeong YH
Ann S
Chung PW
Source :
Cerebrovascular diseases (Basel, Switzerland) [Cerebrovasc Dis] 2024; Vol. 53 (1), pp. 38-45. Date of Electronic Publication: 2023 May 10.
Publication Year :
2024

Abstract

Introduction: The purpose of this study was to identify course of the corticobulbar tract and factors associated with the occurrence of facial paresis (FP) in lateral medullary infarction (LMI).<br />Methods: Patients diagnosed with LMI who were admitted to tertiary hospital were retrospectively investigated and divided into two groups based on the presence of FP. FP was defined as grade 2 or more by the House-Brackmann scale. Differences between the two groups were analyzed with respect to anatomical location of the lesions, demographic data (age, sex), risk factors (diabetes, hypertension, smoking, prior stroke, atrial fibrillation, and other cardiac risk factors for stroke), large vessel involvement on magnetic resonance angiography, other symptoms and signs (sensory symptoms, gait ataxia, limb ataxia, dizziness, Horner syndrome, hoarseness, dysphagia, dysarthria, nystagmus, nausea/vomiting, headache, neck pain, diplopia, and hiccup).<br />Results: Among 44 LMI patients, 15 patients (34%) had FP, and all of them had ipsilesional central-type FP. The FP group tended to involve upper (p < 0.0001) and relative ventral (p = 0.019) part of the lateral medulla. Horizontally large lesion was also related to the presence of FP (p = 0.044). Dysphagia (p = 0.001), dysarthria (p = 0.003), and hiccups (p = 0.034) were more likely to be accompanied by FP. Otherwise, there were no significant differences.<br />Conclusion: The results of present study indicate that the corticobulbar fibers innervating the lower face decussate at the upper level of the medulla and ascend through the dorsolateral medulla, where the concentration of the fibers is densest near the nucleus ambiguus.<br /> (© 2023 The Author(s). Published by S. Karger AG, Basel.)

Details

Language :
English
ISSN :
1421-9786
Volume :
53
Issue :
1
Database :
MEDLINE
Journal :
Cerebrovascular diseases (Basel, Switzerland)
Publication Type :
Academic Journal
Accession number :
37231792
Full Text :
https://doi.org/10.1159/000530986