LATERAL MEDULLARY SYNDROME

60yr known hypertensive female since 5yrs on irregular medication  who's apparently asymptomatic 2days back till afternoon when she had her lunch and washed clothes & at around 2.30pm she suddenly developed Giddiness and swaying towards right side associated with drooping of rt eye lid. She had an episode of vomiting and was taken to outside hospital with support where her BP is 200/100mmhg for which an antihypertensive was given & referred to our hospital.
O/E
Pt c/c/c
Pupils- RE smaller & sluggish reactive.
Speech- ?hoarseness
HMF- Intact
CN- RE- sluggish reactive pupil,
       Placed Mango 🥭 juice on tongue & she said √sed sensation
Gag- +nt
Motor system- Reflexs +nt, power 5/5 , Reflexs- 2+ , plantar - b/L mute
Sensory- face Rt half &  Left half of body
               decreased pain & temp sensation
Cerebellum -
Gait- couldn't be examined as she's having giddiness.

IMP- Lateral medullary syndrome

2Decho is Normal

Treatment:-
Inj.heparin 5000IU QID for 3 day's
Tab.Ecosprin AV 150/20 OD
Tab.Clopitap 75mg OD






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