Lateral Medullary Syndrome (LMS) is a well-documented vascular syndrome of the posterior circulation territory. This syndrome is easily localised because of characteristic presentation, unique territory of blood supply and very small area of involvement. We present a case of Wallenberg's syndrome which did not have all the classical components of the syndrome, like Horner's syndrome. Opalski syndrome is a rare variant of Wallenberg syndrome, where lateral medullary syndrome is associated with ipsilateral hemiparesis. This case report highlights how differential involvement of the lateral part of medulla can result in varied presentation.
A 26-year-old non-smoker, non-alcoholic, male was admitted for the evaluation of chronic abdominal pain which had been persistent for more than six months. He took treatment from different centres, but the pain-relief was only partial. He gave history of passing frequent, foul-smelling stools with Loss of appetite and weight. He had polyuria, there was no polyphagia or polydypsia. He never had cough or fever or vomiting or bleeding per rectum. There was no past or family history of diabetes mellitus or pulmonary tuberculosis.General and clinical examination of cardiovascular system, respiratory system, abdomen, and central nervous system were unremarkable. Complete haemogram, renal and liver function, lipid and thyroid profile, urine and stool examination, electrolytes, calcium and phosphate were normal. Urine for albumin, ketone and Porphyrins were negative. HBsAg, Anti-HCV, Anti-HIV were also negative. ECG and chest X-ray were within normal limits. Fasting blood sugar was 278mg%, post-prandial blood sugar was 486 mg%, and HbAIC was 10.1%. Serum amylase and lipase were slightly elevated which returned to normal after treatment.
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