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Sensory Dermatomal Representation in the Medial Lemniscus
Seung-Hoon Lee, MD;
Dong-Eog Kim, MD;
Eun-Cheol Song, MD;
Jae-Kyu Roh, MD, PhD
Arch Neurol. 2001;58:649-651.
Background Restricted sensory deficits along the somatotopic topography of the
medial lemniscus rarely develop in medial medullary infarction. We describe
a patient with medial medullary infarction who presented with dermatomal sensory
deficits caused by a medial lemniscal lesion.
Case Description A 58-year-old man presented with sudden right-sided hemiparesis and
paresthesia. He had noticed the paresthesia below the level of the right L5
dermatome, where his vibration and position senses were mildly diminished.
His paresthesia was more severe over the right calf and foot. Magnetic resonance
images of the brain showed an acute small infarct in the medial-ventral portion
of the left rostral medulla oblongata. A nerve conduction study and electromyography
showed no abnormalities. At follow-up, the patient's motor and sensory deficits
had improved considerably.
Conclusions The patient showed lemniscal sensory deficits below the right L5 dermatome
that were caused by the partial involvement of the medial lemniscus. These
findings suggest that lemniscal sensory dermatomal representation is preserved
at least up to the level of the medulla oblongata.
From the Department of Neurology, College of Medicine, Seoul National
University and Clinical Research Institute, SNUMRC, and Neuroscience Research
Institute, Seoul National University Hospital, Seoul, Korea.
Corresponding author and reprints: Jae-Kyu Roh, MD, PhD, Department
of Neurology, Seoul National University Hospital, 28 Yongon-dong, Chongno-gu,
Seoul 110-744, Korea (e-mail: rohjk{at}snu.ac.kr).
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