[Isolated Severe Dysphagia Associated with Medial Medullary Infarction: A Case Report and Review of the Literature].

A 59-year-old man developed a sudden onset of vertigo and nausea, and after a few hours, he could not swallow at all. On admission, neurological examination revealed severe dysphagia associated with other transient and mild neurological deficits, including left facial paresis, and hypesthesia in the right side of his body. MRI with diffusion weighted imaging showed a hyperintense signal lesion at the left rostral medial region of the medulla, prompting the diagnosis of an acute medial medullary infarction. His facial paresis and hypesthesia disappeared within 2 weeks. Despite lacking motor paralysis in the tongue, soft palate, and pharyngeal muscle, the patient had severe and prolonged dysphagia. It is speculated that the lesion in this patient is located at the central pattern generator (CPG), which is thought to be the human swallowing center. (Received April 1, 2016; Accepted June 1, 2016; Published October 1, 2016).