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Medial Medullary Syndrome — SCE Neurology MCQ

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ModerateCerebrovascular DiseaseMedial Medullary SyndromeSCE Neurology

A 55-year-old man presents with acute onset of ipsilateral tongue weakness (deviates to the right) and contralateral hemiplegia (left-sided). There is no sensory loss. MRI brain shows a right medial medullary infarct. What is this syndrome called?

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Correct answer: C — Medial medullary syndrome (Dejerine syndrome)

Medial medullary syndrome (Dejerine syndrome) results from occlusion of the anterior spinal artery or paramedian branches of the vertebral artery. It produces ipsilateral tongue weakness and wasting (hypoglossal nucleus/nerve — CN XII), contralateral hemiplegia (corticospinal tract in the pyramid), and contralateral loss of proprioception/vibration (medial lemniscus). A: Wallenberg syndrome is lateral medullary. C: Weber syndrome is a midbrain syndrome (CN III + contralateral hemiplegia). D: Millard-Gubler is a pontine syndrome (CN VI/VII + contralateral hemiplegia). E: Benedikt syndrome is midbrain (CN III + contralateral tremor/ataxia).

Reference: Clinical Neuroanatomy; RCP National Clinical Guideline for Stroke (2023)