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Ipsilateral Hemiparesis in Lateral Medullary Syndrome: A Case Report on Opalski's Syndrome.
Cureus
December 2024
Neurology, Mahatma Gandhi Medical College and Hospital, Jaipur, Jaipur, IND.
Lateral medullary syndrome (LMS) is a neurological disorder usually presenting as loss of pain and thermal sensation over the ipsilateral face and contralateral half of the body, ipsilateral limb ataxia, Horner's syndrome, dysphagia, nystagmus, hiccups among other symptoms but never with limb weakness. In the present case, the patient presented with ipsilateral hemiparesis, which can be attributed to the extension of the infarct caudally beyond the pyramidal decussation, affecting the corticospinal fibers in the upper cervical cord, a variant of LMS, known as Opalski syndrome (OS).
View Article and Find Full Text PDFSpinalTRAQ: A novel volumetric cervical spinal cord atlas identifies the corticospinal tract synaptic projectome in healthy and post-stroke mice.
bioRxiv
October 2024
Department of Neurology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Article Synopsis
- The descending corticospinal tract (CST) is crucial for fine motor skills in the forelimbs, and in rodents, most CST axons cross over at the medullary decussation, impacting their connectivity in the cervical spinal cord.* -
- A novel imaging method called SpinalTRAQ has been developed, allowing for detailed quantitative analysis of CST connections in the cervical spinal cord, revealing specific innervation patterns and structural changes post-injury.* -
- After a focal stroke, CST axons from the injured side are lost, but the remaining axons can sprout new connections, significantly increasing synapse formation in the affected areas by six weeks, demonstrating the potential for recovery following CNS injury.*
Background: Opalski syndrome is a rare variant of Wallenberg syndrome (lateral medullary syndrome) that demonstrates concomitant ipsilateral hemiplegia due to infarctions within the lateral medulla and the cervical spinal cord, which also extend to the post-pyramidal decussation to affect the corticospinal tract.
Case Presentation: A 56-year-old man initially presented with a unilateral headache with right cervical pain. Consequently, he developed symptoms that indicate Wallenberg syndrome: vertigo, dysphonia, dysarthria, right limb ataxia with a tendency to fall, and ptosis, in addition to ipsilateral hemiparesis.
Ventricular Netrin-1 deficiency leads to defective pyramidal decussation and mirror movement in mice.
Cell Death Dis
May 2024
Department of Laboratory Animal Science, Fudan University, Shanghai, 200032, China.
Article Synopsis
- The corticospinal tract (CST) is crucial for voluntary movement in vertebrates, and Netrin-1 serves as a key guidance molecule for axons crossing the midline during embryonic development.
- Research using conditional knockout (CKO) mice revealed that the lack of Netrin-1 resulted in CST axons failing to cross over correctly and instead descending on the same side of the spinal cord.
- These findings suggest a significant role of Netrin-1 in CST formation and provide new insights into its involvement in congenital mirror movements (CMM) due to abnormal CST trajectories.
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