Urinary Retention and Body Lateropulsion by Lateral Medullary Infarction: A Case Report

We describe a case of lateral medullary infarction (LMI) presenting with both body lateropulsion (BL) and urinary retention (UR). A 29-year-old Filipino male with a history of untreated hypertension, dyslipidemia, hyperuricemia, and obesity presented with acute onset of rotatory vertigo, gait disturbance, and left-sided sensory loss. Initial examination revealed horizontal nystagmus to the left, right-sided facial sensory loss, and left-sided limb sensory loss, without cranial nerve deficits or UR. Brain magnetic resonance imaging showed hyperintensities in the right dorsolateral medulla oblongata, leading to a diagnosis of LMI. Antiplatelet therapy and rehabilitation were initiated. Subsequently, the patient developed dysphagia, UR requiring intermittent catheterization, and right-sided Horner's syndrome. He also reported right-sided BL during gait training. Following medical and rehabilitative management, symptoms gradually improved, with the resolution of vertigo and UR by day 20, improved BL by day 40, and independent ambulation by day 70, despite persistent slight sensory disturbance. In this case report, we discuss the causes of BL and UR in LMI, comparing them with previous cases.