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J Stroke Cerebrovasc Dis. 2017 Jan;26(1):e18-e19. doi: 10.1016/j.jstrokecerebrovasdis.2016.10.013. Epub 2016 Nov 7.

Dermatomal Sensory Manifestations in Opalski Syndrome.

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Department of Neurology, Aomori Prefectural Central Hospital, Aomori, Japan. Electronic address:
Department of Neurology, Aomori Prefectural Central Hospital, Aomori, Japan.


A 31-year-old Japanese woman presented with sudden-onset unstable gait followed by nuchal pain. A neurological examination revealed right-sided limb weakness and decreased pain and thermal sensation on the left side below the level of the L1 dermatome. A lower lateral medullary infarction with ipsilateral hemiplegia, known as Opalski syndrome, caused by spontaneous vertebral artery dissection was diagnosed by magnetic resonance imaging. The spinothalamic tract in the medulla oblongata has a topographic arrangement of sensory fibers, and the dermatomal sensory deficit in this case can be explained in relation to that. This is the first reported case of Opalski syndrome with dermatomal sensory manifestations. Opalski syndrome could be a differential diagnosis for dermatomal sensory manifestations.


Dermatomal sensory manifestations; Opalski syndrome; Wallenberg syndrome; lateral medullary infarction; sensory level

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