Opalski氏症候群併發同側小腦梗塞－個案報告

Opalski氏症候群（Opalski syndrome），是一種Wallenberg氏症候群（Wallenberg syndrome）的變異型態，會合併同側肢體無力，出現在6.6%之外側延髓梗塞患者中。一名68歲老年男性，有糖尿病、高血壓、氣喘及右側橋腦梗塞等過去病史，因眩暈、噁心及嘔吐2日求診於本院。理學檢查顯示左側肢體無力及辨距不能，左側肢體震動覺減弱，右側肢體溫度覺減弱，以及向右注視性眼振。然而，病況在入院後第2日開始惡化，出現構音障礙、聲音沙啞、吞嚥困難、左眼鞏膜充血泛紅；入院第3日，左側肢體已經重癱，竟於隔日病危死亡。電腦斷層及磁振造影顯示左側外側延髓、小腦扁桃及下半月葉之急性梗塞，磁振血管造影呈現左側椎動脈完全阻塞，遂診斷為左側Opalski氏症候群併發同側小腦梗塞。英文文獻中有關Opalski氏症候群併發同側小腦梗塞之個案報告僅有3例，本國文獻尚缺，本個案誠屬罕見。

關鍵字

Opalski氏症候群； Wallenberg氏症候群；同側肢體無力；小腦梗塞

並列摘要

As a variant of Wallenberg syndrome and usually complicated with ipsilateral hemiparesis, Opalski syndrome (OPS) has been detected in 6.6% of patients suffering lateral medullary infarction. A 68-year-old man with diabetic mellitus, hypertension, asthma and a previous case of right pontine infarction visited our hospital after experiencing vertigo, nausea, and vomiting for two days. Physical examination demonstrated left hemiparesis and dysmetria, decreased vibration sensation of left limbs, hypothermia of right limbs, and rightward gazing nystagmus. His condition deteriorated on the second day of admission with the occurrence of dysarthria, hoarseness, dysphagia, and left scleral congestion. Left hemiplegia took place on the third day, and the patient expired the next day. Computed tomography and magnetic resonance imaging demonstrated acute infarction of left lateral medulla, cerebellar tonsil, and inferior cerebellar semilunar lobule, while magnetic resonance angiography indicated total occlusion of his left vertebral artery. He was accordingly diagnosed with left OPS with ipsilateral cerebellar infarction. To the best of our knowledge, so far there have been only three OPS case reports in the literature, and all of them written in English. Hence our endeavor in reporting this first OPS case in Taiwan in Chinese.

並列關鍵字

Opalski syndrome ； Wallenberg syndrome ； ipsilateral hemiparesis ； cerebellar infarction

國際替代計量

Opalski氏症候群併發同側小腦梗塞－個案報告

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