Lateral Medullary Syndrome (LMS) is a well studied vascular syndrome of the posterior circulation territory. This syndrome is localised with its typical presentation including vertigo, nystagmus, hoarseness, dysphagia, ipsilateral cerebellar signs and Horner's syndrome with classical crossed sensory deficits, specifically loss of pain and temperature sensation affecting trunk and extremities contralateral to the infarct along with ipsilateral facial numbness. We present a case of Opalski syndrome which is a rare variant of Wallenberg syndrome, where lateral medullary syndrome is associated with ipsilateral hemiparesis and positive Babinski sign. This case report showcases one of the varied presentation of ipsilateral weakness in Lateral Medullary Syndrome or Wallenberg syndrome.
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