REHABILITATION OUTCOME IN A PATIENT WITH LATERAL MEDULLARY SYNDROME

Medullary infarction, a type of brainstem stroke affecting the medulla oblongata, often results in bulbar symptoms such as dysphagia, dysphonia, and dysarthria, significantly impacting a patient's quality of life.Lateral medullary syndrome (Wallenberg's syndrome) is a common manifestation, typically caused by vertebral or posterior inferior cerebellar artery occlusion.This case report presents a 52-year-old female with dorsomedial medullary infarction, exhibiting left-sided hemiparesis, balance impairment, and severe bulbar symptoms.Early multidisciplinary rehabilitation, including physical therapy and speech therapy, was initiated during hospitalisation.Despite improvements in motor function, the patient experienced persistent dysphonia, dysarthria, and swallowing difficulties post-discharge, necessitating continued rehabilitation.Functional assessments, including fiberoptic endoscopic evaluation of swallowing and acoustic voice analysis, identified vocal cord paralysis and dysphagia.Speech therapy was focused on voice rehabilitation, swallowing safety and efficacy, and speech intelligibility, leading to notable functional gains.However, gait instability and balance deficits persisted, requiring longterm physiotherapy interventions.This report underscores the importance of a comprehensive, multidisciplinary approach in managing medullary infarction sequelae.It highlights the role of speech-language pathologists in addressing bulbar dysfunction and emphasises the necessity of ongoing rehabilitation and long-term follow-up for optimising patient outcomes.