延髄内側症候群
WordNet
- dividing an animal into right and left halves (同)median
- a pattern of symptoms indicative of some disease
- a complex of concurrent things; "every word has a syndrome of meanings"
- of or relating to the medulla of any body part
- containing or consisting of or resembling bone marrow
- of or relating to the medulla oblongata
- the inner part of an organ or structure in plant or animal
PrepTutorEJDIC
- 中間の,中間に位置する / 平均の,並なみの
- (疾患の徴候となる一群の)症徴候,症候群 / (事件・社会的状態などのパターンを示す)徴候形態
- 〈U〉骨髄 / =medulla oblongata
- mediumの複数形
Wikipedia preview
出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/09/24 07:51:25」(JST)
[Wiki en表示]
"Dejerine syndrome" redirects here. For other syndromes named after Dejerine, see Joseph Jules Dejerine § Associated eponyms.
| Medial medullary syndrome |
|
Medulla oblongata, shown by a transverse section passing through the middle of the olive. (Medial medullary syndrome can affect structures in lower left: especially #5, #6, #8.)
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| Classification and external resources |
| Specialty |
neurology |
| ICD-10 |
G46.3 |
| eMedicine |
emerg/834 |
Medial medullary syndrome, also known as inferior alternating syndrome, hypoglossal alternating hemiplegia, lower alternating hemiplegia,[1] or Dejerine syndrome,[2] is a type of alternating hemiplegia characterized by a set of clinical features resulting from occlusion of the anterior spinal artery. This results in the infarction of medial part of the medulla oblongata.
Contents
- 1 Pathophysiology
- 2 Presentation
- 3 See also
- 4 References
- 5 External links
Pathophysiology
The infarction leads to death of the ipsilateral medullary pyramid, the medial leminiscus, and the hypoglossal nerve fibers that pass through the medulla. The spinothalamic tract is spared because it is located more laterally in the brainstem and is not supplied by the anterior spinal artery, but rather by the vertebral and posterior inferior cerebellar arteries. The trigeminal nucleus is also spared, since most of it is higher up in the pons, and the spinal part of it found in the medulla is lateral to the infarct.
Presentation
The condition usually consists of:
| Description |
Source of damage |
Number on diagram |
| a deviation of the tongue to the side of the infarct on attempted protrusion, caused by ipsilateral muscle weakness. |
hypoglossal nerve fibers |
#8 |
| limb weakness (or hemiplegia, depending on severity), on the contralateral side of the infarct |
medullary pyramid and hence to the corticospinal fibers of the pyramidal tract |
#5 |
| a loss of discriminative touch, conscious proprioception, and vibration sense on the contralateral side of the infarct |
medial leminiscus |
#6 |
Human brainstem blood supply description. ASA is #13.
Sensation to the face is preserved, due to the sparing of the trigeminal nucleus.
The syndrome is said to be "alternating" because the lesion causes symptoms both contralaterally and ipsilaterally. Sensation of pain and temperature is preserved, because the spinothalamic tract is located more laterally in the brainstem and is also not supplied by the anterior spinal artery (instead supplied by the posterior inferior cerebellar arteries and the vertebral arteries).
See also
- Alternating hemiplegia of childhood
- Lateral medullary syndrome
- Lateral pontine syndrome
- Medial pontine syndrome
References
- ^ "Atlas of Microscopic Anatomy: Section 17 - Central Nervous System. Plate 17.330 Medulla Oblongata". Retrieved 2007-06-07.
- ^ Yokota J, Amakusa Y, Tomita Y, Takahashi S (February 2003). "[The medial medullary infarction (Dejerine syndrome) following chiropractic neck manipulation]". No To Shinkei (in Japanese) 55 (2): 121–5. PMID 12684991.
External links
- http://isc.temple.edu/neuroanatomy/lab/lesions/14.htm
- http://www.neuropat.dote.hu/table/kereszt7.htm
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Cerebrovascular diseases (G45–G46 and I60–I69, 430–438)
|
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Brain ischemia/
cerebral infarction
(ischemic stroke/TIA) |
| TACI, PACI |
- precerebral: Carotid artery stenosis
- cerebral: MCA
- ACA
- Amaurosis fugax
|
|
| POCI |
- precerebral: Anterior spinal artery syndrome
- Vertebrobasilar insufficiency
- Subclavian steal syndrome
- brainstem: medulla
- Medial medullary syndrome
- Lateral medullary syndrome
- pons
- Medial pontine syndrome/Foville's
- Lateral pontine syndrome/Millard-Gubler
- midbrain
- Weber's
- Benedikt
- Claude's
- cerebral: PCA
- Lacunar stroke
- Dejerine–Roussy syndrome
|
|
| General |
- cerebral: Cerebral venous sinus thrombosis
- CADASIL
- Binswanger's disease
- Transient global amnesia
|
|
|
Intracranial hemorrhage
(hemorrhagic stroke) |
| Extra-axial |
- Epidural
- Subdural
- Subarachnoid
|
|
| Cerebral/Intra-axial |
|
|
| Brainstem |
|
|
|
| Aneurysm |
- Cerebral aneurysm
- Intracranial berry aneurysm
- Charcot-Bouchard aneurysm
|
|
| Other/general |
|
|
|
Index of the central nervous system
|
|
| Description |
- Anatomy
- meninges
- cortex
- association fibers
- commissural fibers
- lateral ventricles
- basal ganglia
- diencephalon
- mesencephalon
- pons
- cerebellum
- medulla
- spinal cord
- Physiology
- Development
|
|
| Disease |
- Cerebral palsy
- Meningitis
- Demyelinating diseases
- Seizures and epilepsy
- Headache
- Stroke
- Sleep
- Congenital
- Injury
- Neoplasms and cancer
- Other
- Symptoms and signs
- head and neck
- eponymous
- lesions
- Tests
|
|
| Treatment |
- Procedures
- Drugs
- general anesthetics
- analgesics
- addiction
- epilepsy
- cholinergics
- migraine
- Parkinson's
- vertigo
- other
|
|
Index of the circulatory system
|
|
| Description |
- Anatomy
- Arteries
- head and neck
- arms
- chest
- abdomen
- legs
- Veins
- head and neck
- arms
- chest
- abdomen and pelvis
- legs
- Development
- Cells
- Physiology
|
|
| Disease |
- Congenital
- Neoplasms and cancer
- Lymphatic vessels
- Injury
- Vasculitis
- Other
- Symptoms and signs
|
|
| Treatment |
- Procedures
- Drugs
- beta blockers
- channel blockers
- diuretics
- nonsympatholytic vasodilatory antihypertensives
- peripheral vasodilators
- renin–angiotensin system
- sympatholytic antihypertensives
- vasoprotectives
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|
|
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Lesions of spinal cord and brain
|
|
Spinal cord/
vascular myelopathy |
- sensory: Sensory ataxia
- Tabes dorsalis
- motor: Motor neurone disease
- mixed: Brown-Séquard syndrome
- cord syndrome (Posterior
- Anterior
- Central/Syringomyelia)
- Subacute combined degeneration of spinal cord (B12)
- Cauda equina syndrome
- Anterior spinal artery syndrome
|
|
| Brainstem |
| Medulla (CN 8, 9, 10, 12) |
- Lateral medullary syndrome/Wallenberg
- Medial medullary syndrome/Dejerine
|
|
| Pons (CN 5, 6, 7, 8) |
- Upper dorsal pontine syndrome/Raymond Céstan syndrome
- Lateral pontine syndrome (AICA) (lateral)
- Medial pontine syndrome/Millard-Gubler syndrome/Foville's syndrome(basilar)
- Locked-in syndrome
- Internuclear ophthalmoplegia
- One and a half syndrome
|
|
| Midbrain (CN 3, 4) |
- Weber's syndrome
- Benedikt syndrome
- Parinaud's syndrome
- Nothnagel's syndrome
- Claude's syndrome
|
|
| Other |
|
|
|
| Cerebellum |
- lateral (Dysmetria
- Dysdiadochokinesia
- Intention tremor)
- medial (Cerebellar ataxia)
|
|
| Basal ganglia |
- Chorea
- Dystonia
- Parkinson's disease
|
|
| Cortex |
- ACA syndrome
- MCA syndrome
- PCA syndrome
- frontal lobe: Expressive aphasia
- Abulia
- parietal lobe: Receptive aphasia
- Hemispatial neglect
- Gerstmann syndrome
- Astereognosis
- occipital lobe: Bálint's syndrome
- Cortical blindness
- Pure alexia
- temporal lobe: Cortical deafness
- Prosopagnosia
|
|
| Thalamus |
|
|
| Other |
- Subclavian steal syndrome
- Upper motor neurone lesion (Clasp-knife response)
- Lower motor neurone lesion
|
|
|
Index of the central nervous system
|
|
| Description |
- Anatomy
- meninges
- cortex
- association fibers
- commissural fibers
- lateral ventricles
- basal ganglia
- diencephalon
- mesencephalon
- pons
- cerebellum
- medulla
- spinal cord
- Physiology
- Development
|
|
| Disease |
- Cerebral palsy
- Meningitis
- Demyelinating diseases
- Seizures and epilepsy
- Headache
- Stroke
- Sleep
- Congenital
- Injury
- Neoplasms and cancer
- Other
- Symptoms and signs
- head and neck
- eponymous
- lesions
- Tests
|
|
| Treatment |
- Procedures
- Drugs
- general anesthetics
- analgesics
- addiction
- epilepsy
- cholinergics
- migraine
- Parkinson's
- vertigo
- other
|
|
|
UpToDate Contents
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English Journal
- Clinical review of 37 patients with medullary infarction.
- Fukuoka T, Takeda H, Dembo T, Nagoya H, Kato Y, Deguchi I, Maruyama H, Horiuchi Y, Uchino A, Yamazaki S, Tanahashi N.SourceDepartment of Neurology and Cerebrovascular Medicine, Saitama Medical University International Medical Center, Saitama, Japan. tfukuoka@saitama-med.ac.jp
- Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association.J Stroke Cerebrovasc Dis.2012 Oct;21(7):594-9. doi: 10.1016/j.jstrokecerebrovasdis.2011.01.008. Epub 2011 Mar 4.
- BACKGROUND: Clinical features of medullary infarction were compared between patients with lateral medullary infarction and medial medullary infarctionMETHODS: Thirty-seven patients with medullary infarction (29 with lateral medullary infarction and 8 with medial medullary infarction) who were admitt
- PMID 21376629
- A case of bilateral medial medullary infarction presenting with "heart appearance" sign.
- Tokuoka K, Yuasa N, Ishikawa T, Takahashi M, Mandokoro H, Kitagawa Y, Takagi S.SourceDepartment of Neurology, Tokai University Hachioji Hospital, 1838 Ishikawa, Hachioji, Tokyo 192-0032 Japan. tokuoka.kentaro@hachioji-hosp.tokai.ac.jp
- The Tokai journal of experimental and clinical medicine.Tokai J Exp Clin Med.2007 Sep 20;32(3):99-102.
- Bilateral medial medullary infarction (bilateral MMI) is an extremely rare cerebrovascular accident presenting with quadriplegia as the initial symptom and resulting in poor functional prognosis. Diagnosis of bilateral MMI has become possible based on brain MRI findings in recent years, but is still
- PMID 21318946
Japanese Journal
- Intramedullary Hemorrhage Caused by Arteriovenous Malformation : A Case of Mixed Lateral and Medial Medullary Syndrome
- NOKURA Kazuya,NAKASAWA Hideka,KAMIMOTO Kaoru,KONO Chikao,MATSUBARA Michitaka,KABASAWA Hidehiro,OJIKA Kosei,KOGA Hiroshi,YAMAMOTO Hiroko
- Journal of stroke and cerebrovascular diseases : official publication of the National Stroke Association 10(1), 30-33, 2001-01-00
- NAID 10007742014
- Dejerine症候群の三徴を示さず,診断に難渋した延髄内側梗塞の1例
- Sensory sequelae of medullary infarction : differences between lateral and medial medullary syndrome
Related Links
- 中間の髄質シンドローム (また知られているとして Dejerine シンドローム) 一組の臨床特徴はありに起因する 梗塞形成 brainstem。 通常含まれる容器はである 前方の背骨動脈 の中間の部分を供給するかどれが 髄質のoblongata。
- Notes Rare stroke syndrome (1% of vertebrobasilar strokes, Bassetti et al., 1994). Medial medullary infarct is associated with clinical triad of ipsilateral hypoglossal palsy, contralateral hemiparesis, and contralateral lemniscal sensory ...
★リンクテーブル★
[★]
- 同
- medial medullary syndrome, MMS
- 同
- デジュリーヌ症候群 Dejerine syndrome
- 関
- 舌下神経交叉性片麻痺症候群。延髄外側症候群 LMS = ワレンベルグ症候群
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- center、central、centre、centro、centrum、hub、inner、inside、interior、medialis、medially、middle
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- 関
- bulbar、medulla、medulla oblongata
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- culture、culture media、culture medium、culture solution、medium
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