Lateral Medullary Syndrome Presenting as Section Persistent Singultus and Upper Motor Neuron Facial Palsy in a young Adult: A Rare Case

Abstract

Lateral Medullary Syndrome (LMS) is a collection of different neurologic symptoms after cerebral haemorrhage/infarction. The areas most frequently afflicted are the cerebellum and the posterolateral portion of the brain stem’s medulla oblongata; the Posterior Inferior Cerebellar Artery (PICA) supplies blood. Dizziness, vertigo, nystagmus, nausea, ataxia, dysphagia, vomiting, hiccups, hoarseness, sensation impaired on half of the face, impaired thermal sensation and pain on the contralateral side of the limbs, trunk, ipsilateral face, along with Horner’s syndrome are amongst the typical symptoms of lateral medullary infarction. Hiccups are among the signs that are simple to ignore, although they can also result in oesophagitis, and respiratory depression, as Wallenberg’s syndrome is the most frequently reported. The authors discuss the case of a 30-year-old male who complained of recurrent, uncontrollable hiccups as an LMS-presenting symptom and was brought to our hospital. He arrived at our emergency room complaining of persistent, intractable hiccups and cerebellar symptoms on the left-side. In addition to being hypertensive, he had a long history of tobacco (chewing) and alcohol addictions dating back six years. He had 7, 9 and 10th cranial nerve involvement. The authors are reporting this case because the patient had Upper Motor Neuron (UMN)-type facial palsy, a rare presentation in LMS.

Keywords

• hiccups
• posterior inferior cerebellar artery
• stroke