Bilateral Medial Medulla Infarction Mimicking Guillain-Barré Syndrome and its Variants Saro Kobayashi 1 , Keisuke Suzuki 1 , Hidehiro Takekawa 1,2,3 , Yuji Watanabe 1 , Madoka Okamura 1 , Ayano Suzuki 1 , Daisuke Tsukui 1 , Koichi Hirata 1 1Department of Neurology, Dokkyo Medical University 2Stroke Center, Dokkyo Medical University 3Center of Medical Ultrasonics, Dokkyo Medical University Keyword: 両側延髄内側梗塞 , Guillain-Barré症候群 , 四肢麻痺 , 呼吸障害 , bilateral medial medulla infarction , Guillain-Barré syndrome , tetraplegia , respiratory failure pp.901-905
Published Date 2020/8/1
DOI https://doi.org/10.11477/mf.1416201617
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A 70-year-old man presented with dizziness and unsteadiness when standing and was hospitalized in another hospital. Magnetic resonance imaging (MRI) of the brain on Day 1 showed no abnormalities. The patient developed respiratory failure on Day 1and flaccid tetraplegia on Day 3, and was transferred to our hospital. Progressive upper and lower limb weakness and bulbar symptoms suggested Guillain-Barré syndrome or its variant. Diffusion-weighted MRI on Day 6 disclosed high signal intensities in the bilateral medial portion of the medulla, and the patient was diagnosed with bilateral medial medulla infarction. Bilateral medial medulla infarction should be considered when a patient shows progressive tetraplegia, and bulbar palsy and follow-up MRI is important to confirm the diagnosis.

(Received January 23, 2020; Accepted April 21, 2020; Published August 1, 2020)

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