[Blepharoptosis and dysarthria in a boy aged 2 years]

Area of Science:

• Neurology
• Pediatrics
• Neuroimaging

Background:

• Dorsolateral medulla oblongata syndrome is a rare neurological condition.
• Infantile cases are exceptionally uncommon, presenting diagnostic challenges.

Observation:

• A 2-year-old boy experienced sudden right eyelid ptosis, right-sided mouth deviation, cough, nystagmus, and developmental regression.
• Cranial MRI revealed infarction-induced lesions in the right dorsolateral medulla oblongata.
• CT angiography showed no visualization of the right vertebral artery's proximal V4 segment.

Findings:

• The patient was diagnosed with dorsolateral medulla oblongata syndrome.
• Treatment included gamma globulin, mannitol, low-molecular-weight heparin sodium, hyperbaric oxygen, and neuromuscular electrical stimulation.
• Post-treatment, residual symptoms included mild right ataxia and Horner syndrome.

Implications:

• This report details the first pediatric case of dorsolateral medulla oblongata syndrome.
• The findings offer crucial diagnostic and therapeutic experience for this rare infantile neurological disorder.
• Early intervention and multimodal treatment are key to improving outcomes in affected children.