[A case of bilateral upper medial medullary infarction]

A clinical case of bilateral upper medial medullary infarction was reported. A 61-year-old woman was admitted to our hospital because of numbness of trunk and bilateral upper and lower limbs, aphonia and left-hemiparesis, which progressed to quadriplegia. Facial movements were intact. Her tongue was not fully protruded and deviated to the right side. Impairment of the position sense was noted in bilateral lower limbs. Respiratory failure was not observed. A brain MRI revealed a high-intensity area on T2-weighted imaging in the upper medulla oblongata. The lesion involved the medial medulla oblongata bilaterally. No lesions were present in the other brain parenchyma. According to the literature, respiratory failure was present in almost all patients with bilateral medial medullary infarction. The findings of our patient suggest that respiratory failure is not induced by the bilateral medial medullary infarction limited to the upper medulla oblongata.