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A sensory level on the trunk and sparing the face from vertebral artery dissection: how much more subtle can we get?
  1. THANH G PHAN,
  2. EELCO F M WIJDICKS
  1. Department of Neurology, Mayo Medical Center and Foundation, Rochester, MN, USA
  1. Dr E F M Wijdicks, Mayo Clinic, Department of Neurology (W8A), Correspondence to: E F M Wijdicks, MD, 200 First Street SW, Rochester, MN 55905, USA. Telephone 001 507 284 5443; fax 001 507 284 4795; email wijde{at}mayo.edu

https://doi.org/10.1136/jnnp.66.5.691

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    We read with interest the short report on sensory loss in lateral medullary infarction by Vuadens and Bogousslavsky.1 Unusual sensory variants include contralateral leg and lower trunk with ipsilateral lower face hypalgesia; or contralateral upper trunk, arm, and face hypalgesia; or contralateral hypalgesia with facial sparing; or hemibody sensory loss.1-3 We recently encountered a patient with sensory loss of the spinothalamic type involving only the contralateral leg and lower trunk from vertebral artery dissection. The sensory level in our patient with facial sparing differs from those in the literature; it suggests a thoracic hemicord lesion and is false localising.

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