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October 1980

Uncommon Causes of the Lateral Medullary Syndrome: Report of a Case of Metastatic Carcinoma

Author Affiliations

From the Department of Pathology, Wayne State University School of Medicine, Detroit.

Arch Neurol. 1980;37(10):669-670. doi:10.1001/archneur.1980.00500590093018

The symptoms that constitute the lateral medullary syndrome are well established.1-3 The majority are due to infarction,4 but neoplasm,5-7 vascular malformation,8 radionecrosis,9 and abscess10 also can produce it. Those unusual cases are listed in the Table. I describe a patient in whom the syndrome was caused by metastatic oat cell carcinoma.

REPORT OF A CASE  A 41-year-old woman was asymptomatic for a year following lobectomy and radiation therapy for an oat cell carcinoma of the right upper lobe. She was then hospitalized for headache, nausea, ataxia, slurred speech, and progressive lethargy.Examination revealed severe dysphasia and dysarthria with absent left palatal elevation. She had a broad-based, slow, and markedly ataxic gait with a tendency to fall to the left. Mild papilledema existed. Pupils were equal and reacted normally. There was horizontal nystagmus on lateral gaze to the right. Ptosis of the left eye was

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