Opalski Syndrome; A rare variant of Wallenberg Syndrome: A case report and literature review

Abstract

Abstract Background Opalski Syndrome, first described in 1946, is a rare variant of Wallenberg Syndrome (Lateral Medullary Syndrome) associated with ipsilateral hemiplegia, which is attributed to concomitant lateral medullary and cervical spine infarction and its extension downwards to comprise the post-pyramidal decussation corticospinal tract. Case presentation We report a case of a 56-year-old man who initially complained of unilateral headache with right cervical pain, and after a brief period, developed Wallenberg Syndrome’s classical symptoms-vertigo, dysphonia, and dysarthria, right limb ataxia with a tendency to fall, ptosis- in addition to ipsilateral hemiparesis. Initial diffusion weighted-imaging magnetic resonance imaging (DWI MRI) results were suggestive of an acute infarct in the dorsolateral medulla. A hyperintense focal region in the dorsolateral medulla was visible on an axial T2-weighted MRI. According to magnetic resonance angiography (MRA), the right vertebral artery revealed complete stenosis. Conclusion This interpretation demonstrates that Opalski Syndrome must be considered when findings suggest lateral medullary infarction in patients who also experience ipsilateral hemiparesis with hyperacute onset.