[A case of central pain observed in medical medullary infarction]

Abstract

A 45-year-old man had typical features of the left medial medullar syndrome which were left tongue paralysis, right hemiparesis, and right disturbance of touch and deep sensation sparing the face. He complained of hyperpathia, numbness and pain of the right body and limb sparing the face. MRI disclosed left upper medial medullary infarction, and cerebral angiography revealed occlusion of the left vertebral artery before the posterior inferior cerebellar artery. In general, the touch and deep sensation are carried through the medial lemniscus located in the medial medulla, therefore central pain is not considered to be induced by the medial medullary lesion. But tingling and numb sensation were sensory symptoms in our patient and the cases previously reported. If spinocervicothalamic tract related to touch and pain sensation has been well developed, it is suspected that central pain is induced by disturbance of the tract.