Medial medullary infarction with contralateral glossoplegia

There is a relative lack of information on the course of corticohypoglossal projections in the human brain stem, 2 especially in the medulla. Using transcranial magnetic stimulation and magnetic resonance imaging (MRI) in 11 patients with ischaemic lesions at different brain stem levels, Urban et al showed that pontine lesions at the ventral paramedian base close to the midline affected the contralateral corticohypoglossal projections, while lateral lesions at the pontine base affected the ipsilateral projections. Lesions of the dorsolateral and mediolateral medulla impaired only ipsilateral corticohypoglossal projections. We report a patient with contralateral glossoplegia in the ventromedial lesion of the upper medulla.