Application of Acute Physical Therapy in Respiratory Failure Secondary to Bilateral Medial Medullary Infarction and Long-Term Follow-Up: A Case Report.

Bilateral medial bulbar infarction (BMMI) represents a rare yet critical form of posterior circulation ischemic stroke encountered in clinical practice. The condition progresses rapidly and is associated with a heightened risk of secondary central respiratory failure, severe pulmonary infection, and multiple systemic functional impairments, including dysphagia, limb paralysis, and sensory abnormalities. Consequently, both the disability and mortality rates remain elevated. Currently, systematic clinical studies focusing on early physical intervention, phased rehabilitation programs, and long-term prognosis follow-up for patients with BMMI during the acute phase are relatively limited. This report reviews the clinical diagnosis and treatment, early acute physical therapy, and two-year long-term rehabilitation follow-up data of a 53-year-old male patient with BMMI, who presented with acute central respiratory failure, severe pulmonary infection, and pronounced bulbar palsy. It summarizes the clinical progression characteristics, stepwise rehabilitation intervention strategies, and prognostic patterns associated with this condition. The objective is to provide a clinical reference for early rehabilitation interventions, the formulation of individualized treatment plans, and the assessment of long-term prognosis for patients with BMMI complicated by severe multi-system dysfunction.