Case report -Opalski's syndrome A rare variant of lateral medullary syndrome in TAKAYASUS ARTERITIS

Abstract

we present an interesting case of Opalskis
syndrome which is an unusual manifestation
of Lateral Medullary Syndrome
in addition this patient also has features
suggestive of Takayasus arteritis. 42
year female, known diabetic presented
with left upper limb claudication and recurrent
transient ischemic attacks for the
past 3 months, with recent sudden onset
of left hemiparesis, left 9th 10th cranial
nerve palsy, sensory loss in right half of
the body and left half of the face with left
cerebellar signs. She had absent pulse in
left upper limb and significant BP variation
in both upper limbs (BP-right upper
limb 11070 mm of Hg, left upper limb not
recordable) normal pulse and BP in the
lower limbs showing some of the clinical
features suggestive of Takayasus arteritis.
Her CT scan brain showed left cerebellar
infarct, MRI brain revealed acute
infarct in left medulla, with rostral spinal
cord extension, cerebellar vermis, right
occipital lobe, right thalamus, MRA brain
was normal, CT Angiogram showed left
Subclavian artery occlusion at its origin
from the aorta, with faint reformation of distal
axillary and brachial artery from the lateral
thoracic artery. Patient underwent
medical management and improved well
and regular follows up.