Babinski-Nageotte Syndrome: Case Report of a rare variant of Lateral Medullary Infarction

Babinski-Nageotte Syndrome: Case Report of a rare variant of Lateral Medullary Infarction

Arunava Saha, MD¹; Kamal Pokhrel, MD¹; Gary Keilson, MD²

^1.Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA; ^2.Chief, Department of Neurology, Saint Vincent Hospital, Worcester, MA

Babinski-Nageotte Syndrome (BNS) is a rare variant of lateral medullary infarction, and only a few cases have been reported. In this case, a 52-year-old African-American gentleman presented with acute onset weakness on the left side of the body. On examination, there was a palpable right supraclavicular lymph node. Neurological examination showed right-sided gaze-evoked nystagmus and left hemiparesis with grade 3/5 power. Reflexes were normal except for extensor plantar responses on the left. MRI showed a subacute right-sided lateral brainstem infarct just below the pontomedullary junction with minimal progression in a repeat MRI after 24 hours. Workup for supraclavicular adenopathy with CT chest and CT abdomen and pelvis revealed neither neoplastic nor metastatic disease. Biopsy of supraclavicular lymph node was planned as an outpatient but was deferred as it was presumed to be reactive. He was conservatively managed with daily physiotherapy, aspirin, atorvastatin, and optimal blood pressure control. Babinski-Nageotte syndrome includes all symptoms of the Wallenberg syndrome with contralateral hemiparesis due to a spread of the lateral lesion to the pyramidal tract. Atherosclerotic occlusion and lipohyalinosis of the vertebral artery and posterior inferior cerebellar artery have been identified as the most common causes.

DECLARATIONS OF INTEREST: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Keywords: Case Report, Lateral Medullary Infarct, Babinski-Nageotte, Wallenberg, Hemi-medullary syndrome.

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How to cite this article:

Arunava Saha,Kamal Pokhrel, Gary Keilson. Babinski-Nageotte Syndrome: Case Report of a rare variant of Lateral Medullary Infarction. International Journal of Case Reports, 2022, 6:278. DOI: 10.28933/ijcr-2022-06-3005askp

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