ABSTRACT
Sneezing is known to precede lateral medullary syndrome (LMS). It is usually interpreted as the precipitating cause for a vertebral artery dissection that subsequently causes LMS. Through two case reports and a literature review, we aim to challenge the concept that sneezing at the onset of LMS implies that a dissection is the underlying cause. An 82-year-old man and a 54-year-old man both reported unprovoked explosive pathological sneezing at the onset of the LMS without any delay between sneezing and the other LMS symptoms. Both denied neck trauma or neck pain. There was no conclusive evidence for vertebral artery dissection in either case. Paroxysmal sneezing can be an initial manifestation of lateral medullary ischemia and may not necessarily indicate an underlying vertebral artery dissection as the cause.
Subject(s)
Lateral Medullary Syndrome/complications , Lateral Medullary Syndrome/pathology , Sneezing , Aged, 80 and over , Humans , Magnetic Resonance Angiography , Magnetic Resonance Imaging , Male , Middle Aged , Tomography, X-Ray ComputedABSTRACT
Sclerodermatous skin changes and systemic sclerosis have been reported to occur as a result of contact with several different organic solvents. We describe a 41-year-old man who developed systemic sclerosis after working for 15 years in a foundry, where he had extensive cutaneous contact with multiple organic solvents (trichloroethane, xylene, trimethylbenzene, and naphthalene). Cutaneous exposure to organic solvents may be a factor in the etiology of some cases of systemic sclerosis.
