Home Medicine A rare case of Opalski syndrome with a suspected multiple sclerosis etiology
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A rare case of Opalski syndrome with a suspected multiple sclerosis etiology

  • Shanshan Ma ORCID logo , Xiuping Zhang ORCID logo , Liu Zhao ORCID logo , Fei Peng ORCID logo , Yanhui Xing , Ruiping Wang and Xiaohong Chen ORCID logo EMAIL logo
Published/Copyright: December 17, 2025
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Open Medicine
From the journal Open Medicine Volume 20 Issue 1

Abstract

Objectives

Opalski syndrome is a rare lateral medullary variant that combines classic Wallenberg signs with ipsilateral hemiparesis, resulting from lesions affecting the corticospinal fibers below the pyramidal decussation. Stroke is the predominant cause of Opalski syndrome, and to date, no cases have been reported in association with multiple sclerosis (MS).

Case presentation

A 56-year-old man with hypertension developed dizziness, right-sided weakness, and gait instability. Examination revealed right-sided Horner’s syndrome, hemiparesis, facial numbness, truncal ataxia, crossed sensory loss, and a positive Babinski sign. MRI demonstrated an acute infarction in the right dorsolateral medulla, along with multiple T1 and FLAIR hyperintensities in the periventricular white matter, basal ganglia, corpus callosum, and the C5–C6 spinal cord. Magnetic resonance angiography (MRA) findings were unremarkable. The patient declined lumbar puncture. A diagnosis of Opalski syndrome was established, and multiple sclerosis (MS) was proposed as a potential underlying etiology. Management included dual antiplatelet therapy, statin, vitamins, and physiotherapy, leading to gradual improvement with mild residual deficits.

Conclusions

This may represent the first case of Opalski syndrome linked to suspected MS, highlighting the importance of considering non-vascular etiologies in atypical lateral medullary presentations.

Keywords: Opalski syndrome; lateral medullary syndrome; multiple sclerosis; non-vascular etiology; case report

Background

Opalski syndrome, a rare clinical entity that was initially described in 1946 [1], represents a unique variant of lateral medullary syndrome (LMS), which is also known as Wallenberg syndrome. This syndrome is characterized by the presence of classic LMS symptoms in conjunction with ipsilateral hemiparesis [2], 3]. The underlying pathology of Opalski syndrome involves a lesion localized to the lateral medulla oblongata, a crucial region of the brainstem responsible for a wide range of vital functions and neurological pathways. While the exact anatomical location of the lesion can vary, it mainly influences the corticospinal fibers below the pyramidal decussation [4].

Clinically, Opalski syndrome manifests with a distinct constellation of neurological deficits. The most notable feature is ipsilateral hemiparesis, distinguishing it from the more common crossed neurological findings observed in classic LMS [4]. This hemiparesis is mainly accompanied by several hallmark symptoms of LMS, including vertigo, nausea, vomiting, dysphagia, nystagmus, and ataxia [5]. Sensory disturbances are also frequently observed, characterized by ipsilateral facial sensory loss (affecting pain and temperature sensation) and contralateral body hemianesthesia below the neck [4], 6]. Ipsilateral Horner’s syndrome, characterized by a triad of miosis, ptosis, and anhidrosis, may also be present [7]. The specific combination and severity of these symptoms vary among individuals, which complicates the diagnostic process for this condition.

The most common cause of LMS is stroke, typically resulting from occlusion of the vertebral artery or its branches, particularly the posterior inferior cerebellar artery (PICA) [7], 8]. The underlying mechanisms of vascular compromise include atherosclerosis, embolism, or arterial dissection [9], 10]. Although less common, non-vascular conditions, such as multiple sclerosis (MS), tumors, infections, and traumatic injuries may also cause LMS [11], [12], [13], [14]. While Wallenberg syndrome caused by MS mimicking a stroke has been documented [11], no similar case of Opalski syndrome has been reported. In this study, a case of Opalski syndrome involving the upper cervical spinal cord was reported. The magnetic resonance imaging (MRI) features of the central nervous system and the underlying etiology were analyzed to enhance the diagnosis and treatment of this condition.

Case presentation

A 56-year-old man was admitted with a 3-day history of sudden dizziness, right-sided weakness, and unsteady gait, predominantly leaning to the right. His symptoms began suddenly upon waking, initially mild and transient, while worsened the day before admission, when he experienced multiple episodes of dizziness, nausea, and vomiting, within 20 min after sexual intercourse. These episodes were accompanied by increasing right-sided weakness and gait instability. The patient had a 20-year history of hypertension and a suspected ischemic stroke 8 years earlier, which fully resolved with treatment. At that time, MRI revealed high signal intensity in the left basal ganglia, as well as abnormalities in the corpus callosum, centrum semiovale, and brainstem, indicative of ischemia. In the following years, the patient experienced multiple episodes of dizziness, accompanied by unsteady walking, each lasting from one to several days, which resolved spontaneously without the need for medical intervention. He had abstained from smoking and alcohol for the past 8 years.

On neurological examination, he exhibited right-sided Horner’s syndrome, bilateral restricted leftward eye movement, right lower facial weakness, right-sided hemiparesis with upper motor neuron signs, truncal ataxia, and a positive Babinski sign. His NIHSS score was 4.

Laboratory findings showed mild leukocytosis with neutrophilia, lymphopenia, and elevated homocysteine levels. Thyroid function tests revealed low triiodothyronine (T3) and elevated anti-thyroid antibody levels.

Brain MRI revealed an abnormally high signal corresponding to an ischemic infarct in the right dorsolateral medulla, consistent with a diagnosis of lateral medullary syndrome (Figure 1). Magnetic resonance angiography (MRA) of the head and neck displayed no significant stenosis or occlusion (Figure 2a and b). Additionally, multiple T1 and FLAIR hyperintensities were identified in the bilateral basal ganglia, periventricular white matter, centrum semiovale, and corpus callosum, as well as abnormalities at the C5-C6 levels of the cervical spinal cord (Figure 2c and d). A diagnosis of Opalski syndrome was made based on the clinical presentation and imaging findings. Conventional MRI (Figure 3) revealed patchy areas of prolonged T1WI and FLAIR signals in the white matter surrounding the lateral ventricles, corpus callosum, and cortex, with “black hole” changes in some lesions. FLAIR sequences demonstrated lesion expansion and irregular ventricular walls (Figure 4a and b). Contrast-enhanced MRI revealed an open ring sign in the medullary lesions, with no significant spinal cord enhancement (Figure 4c), raising the suspicion of a demyelinating disease, such as multiple sclerosis (MS). Although the lumbar puncture could provide additional diagnostic information, the patient and his family declined the procedure.

Figure 1: Axial diffusion-weighted MR images (a) showing a focal area of diffusion restriction in the right dorsolateral medulla (white arrow), suggestive of an acute infarct. Axial diffusion-weighted imaging of the middle medulla demonstrating the acute infarct of the right medulla (c). The ADC map (b and d) reveals a corresponding positive lesion (arrow) in the medulla.
Figure 1:

Axial diffusion-weighted MR images (a) showing a focal area of diffusion restriction in the right dorsolateral medulla (white arrow), suggestive of an acute infarct. Axial diffusion-weighted imaging of the middle medulla demonstrating the acute infarct of the right medulla (c). The ADC map (b and d) reveals a corresponding positive lesion (arrow) in the medulla.

Figure 2: Magnetic resonance angiography (MRA) shows no significant stenosis or occlusion of the intracranial or extracranial vessels (a and b). T2/FLAIR hyperintensities in the cervical spinal cord at the C5-C6 levels (c and d).
Figure 2:

Magnetic resonance angiography (MRA) shows no significant stenosis or occlusion of the intracranial or extracranial vessels (a and b). T2/FLAIR hyperintensities in the cervical spinal cord at the C5-C6 levels (c and d).

Figure 3: Magnetic resonance sequences showed round, oval, banded and patchy long T1WI (a, c, d) and flair signals (b) in the white matter around the lateral ventricles, the center of the hemioval, the corpus callosum and the cortical lobe. T1WI signals of some lesions showed “black hole” changes.
Figure 3:

Magnetic resonance sequences showed round, oval, banded and patchy long T1WI (a, c, d) and flair signals (b) in the white matter around the lateral ventricles, the center of the hemioval, the corpus callosum and the cortical lobe. T1WI signals of some lesions showed “black hole” changes.

Figure 4: T1WI (a) and flair (b) sequence showed obvious hypersignal changes, including the increase of lesions, the enlargement of the scope, the rough ventricle upper wall. Head enhanced MRI showed slightly open ring sign in the medulla oblongata lesions (c). There was no significant enhancement in spinal cord enhanced MRI (d).
Figure 4:

T1WI (a) and flair (b) sequence showed obvious hypersignal changes, including the increase of lesions, the enlargement of the scope, the rough ventricle upper wall. Head enhanced MRI showed slightly open ring sign in the medulla oblongata lesions (c). There was no significant enhancement in spinal cord enhanced MRI (d).

After ruling out tumors, infections, and inflammatory diseases, conservative treatment of ischemic stroke was initiated, including aspirin, clopidogrel, atorvastatin, and physiotherapy. Intravenous thrombolysis was not administered due to the time elapsed since symptom onset. During the 10-day hospital stay, the patient’s right-sided weakness, dizziness, and gait instability gradually improved, along with the right-sided Horner’s syndrome, which showed a reduction in facial anhidrosis.

Ethical approval and consent for publication

Individual case reports do not require formal Institutional Review Board approval. Written informed consent for publication of the clinical data and images was obtained from the patient.

Discussion

This case report presented a 56-year-old male patient with Opalski syndrome, a rare variant of LMS. This case is particularly unique as the patient also presented with features suggestive of MS, such as multiple T1 and FLAIR hyperintensities in the bilateral basal ganglia, periventricular white matter, centrum semiovale, and corpus callosum, as well as abnormal signals in the cervical spinal cord at the C5-C6 levels. To our knowledge, Opalski syndrome associated with possible MS has not been previously reported in the medical literature, suggesting that this may be the first documented case.

Opalski syndrome is typically characterized by classic LMS symptoms, alongside ipsilateral hemiparesis [4]. In this case, the patient presented with right-sided Horner’s syndrome, bilateral restricted leftward eye movement, right lower facial weakness, right-sided hemiparesis, right-sided truncal ataxia, and a positive Babinski sign on the right side. These neurological deficits, combined with MRI findings of an ischemic infarct in the right dorsolateral medulla, consistent with LMS, confirmed the diagnosis. Despite ischemic infarction being the most common cause of LMS, the patient’s imaging raised the possibility of an underlying non-vascular etiology, particularly MS. Imaging revealed several features that pointed towards a demyelinating process. Apart from the medullary infarct, multiple FLAIR hyperintensities were identified in the basal ganglia, white matter, corpus callosum, and cervical spinal cord. Furthermore, conventional MRI sequences revealed prolonged T1WI and FLAIR signals with “black hole” changes, indicative of chronic demyelination (Figures 3 and 4). Contrast-enhanced MRI also demonstrated an open-ring sign in the medullary lesions, which is characteristic of demyelinating diseases, such as MS (Figure 4c).

Differentiating Opalski syndrome from other conditions with similar presentations was crucial in this case. Other variants of Wallenberg syndrome, brainstem infarcts in regions other than the lateral medulla, as well as potential neoplastic, infectious, and inflammatory etiologies were considered. The patient’s recurrent neurological events and MRI findings strongly favored MS as the most plausible underlying diagnosis. Notably, the patient had a suspected cerebral infarction 8 years earlier, and current imaging revealed disseminated lesions in the periventricular and cortical regions, cerebellum, and spinal cord. According to the 2024 revisions of the McDonald criteria [15], MS can be diagnosed in typical cases when a compatible clinical syndrome is accompanied by MRI evidence of dissemination in space across characteristic CNS regions, with supportive evidence of dissemination in time, provided that alternative diagnoses are carefully excluded. In our patient, multifocal lesions involving the supratentorial white matter, infratentorial structures, and the cervical spinal cord fulfill dissemination in space, while the remote suspected vascular event and subsequent recurrent transient neurological episodes provide supportive evidence of dissemination in time. In addition, demyelinating-appearing cervical cord lesions are uncommon in chronic small-vessel ischaemic disease and therefore increase the specificity of an MS diagnosis in an individual over 50 years of age with vascular risk factors. Although CSF analysis remains an important supportive tool to increase diagnostic confidence and to exclude alternative inflammatory or infectious disorders, it is not mandatory in all patients under the updated criteria and was not performed in this case because lumbar puncture was declined.

MS, though an uncommon cause of LMS, has been documented in the literature. Smith et al. reported a case of Wallenberg syndrome due to demyelination identified post-mortem, even though the patient had not fulfilled clinical MS criteria [16]. Similarly, Qiu et al. described a case of incomplete Wallenberg syndrome as the initial manifestation of MS [11]. These reports highlight the ability of MS to mimic stroke, especially in atypical presentations, lacking vascular abnormalities on imaging. In our patient, the open-ring sign found on the contrast-enhanced MRI and the scattered lesions in the white matter and corpus callosum further reinforced the possibility of MS.

The mechanisms by which MS could lead to Opalski syndrome likely involve inflammation and demyelination of the lateral medulla, influencing key structures, such as the corticospinal tract. These processes could explain the hemiparesis and other neurological characteristic of Opalski syndrome. While vascular occlusion of the vertebral artery or posterior inferior cerebellar artery (PICA) remains the primary cause of LMS [7], 8], this case underscores the potential of non-vascular etiologies, such as MS, to cause similar syndromes.

In addition to MS, other non-vascular causes of LMS have been reported, including tumors, infections, and trauma. Ho et al. described a case of LMS caused by small-cell carcinoma, where metastatic spread to the lateral medulla led to stroke-like symptoms [13]. Kovacs et al. reported a case of LMS following varicella infection, suggesting a vasculitic mechanism [12]. Viral infections have also been implicated in LMS, as Román-Campos et al. described a fatal case of LMS caused by brainstem encephalitis due to herpesvirus [17]. Additionally, Lawson-Smith et al. documented that trauma can cause LMS, as illustrated by a case involving a low-velocity penetrating injury in an intravenous drug user [14]. These outcomes highlight the broad differential diagnosis for LMS and the importance of considering both vascular and non-vascular causes.

This case report has several limitations. The lack of long-term follow-up data and the patient’s refusal to undergo lumbar puncture could hinder the ability to establish a definitive diagnosis of MS. Although the multifocal lesions and open-ring enhancement pattern raise suspicion of a demyelinating process, the long asymptomatic interval and the absence of cerebrospinal fluid analysis preclude us from further increasing the diagnostic certainty for MS and from fully excluding other demyelinating or ischaemic etiologies. Further investigation and longitudinal follow-up are necessary to clarify the underlying pathology and to deeply understand the potential association between MS and Opalski syndrome.

In conclusion, this study presented a distinctive case of Opalski syndrome potentially linked to MS, which may be the first such case documented in the literature. It highlights the importance of considering non-vascular causes, particularly MS, in cases of Opalski syndrome, especially when atypical clinical or radiological findings are present.

Corresponding author: Xiaohong Chen, Department of Neurology, Liaoning Province Jinqiu hospital, No.317 Xiaonan Street, Shenhe District, Shenyang, 110016, China, E-mail:

Acknowledgments

The authors would like to thank the patient and his family for their cooperation. We thank Medjaden Inc. for the language editing of this manuscript.

  1. Funding information: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

  2. Author contribution: SM: Writing – review & editing, Conceptualization, Methodology, Project administration; XZ: Writing – review & editing; LZ: Writing – review & editing; FP: Writing – review & editing; YX: Writing – review & editing; RW: Writing – review & editing, Formal Analysis; XC: Writing – original draft, Conceptualization, Methodology. All authors have reviewed the final version of this manuscript and agreed to be accountable for all aspects of the study.

  3. Conflict of interest: The authors declare that they have no competing interests.

  4. Data Availability Statement: No data were utilized for the research described in the article.

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Received: 2025-08-11
Accepted: 2025-12-01
Published Online: 2025-12-17

© 2025 the author(s), published by De Gruyter, Berlin/Boston

This work is licensed under the Creative Commons Attribution 4.0 International License.

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  107. Peptide CCAT1-70aa promotes hepatocellular carcinoma proliferation and invasion via the MAPK/ERK pathway
  108. Electroacupuncture-induced reduction of myocardial ischemia–reperfusion injury via FTO-dependent m6A methylation modulation
  109. Hemorrhoids and cardiovascular disease: A bidirectional Mendelian randomization study
  110. Cell-free adipose extract inhibits hypertrophic scar formation through collagen remodeling and antiangiogenesis
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  113. Risk and prognosis for brain metastasis in primary metastatic cervical cancer patients: A population-based study
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  115. Factors influencing hematological toxicity and adverse effects of perioperative hyperthermic intraperitoneal vs intraperitoneal chemotherapy in gastrointestinal cancer
  116. Endotoxin tolerance inhibits NLRP3 inflammasome activation in macrophages of septic mice by restoring autophagic flux through TRIM26
  117. Lateral transperitoneal laparoscopic adrenalectomy: A single-centre experience of 21 procedures
  118. Petunidin attenuates lipopolysaccharide-induced retinal microglia inflammatory response in diabetic retinopathy by targeting OGT/NF-κB/LCN2 axis
  119. Procalcitonin and C-reactive protein as biomarkers for diagnosing and assessing the severity of acute cholecystitis
  120. Factors determining the number of sessions in successful extracorporeal shock wave lithotripsy patients
  121. Development of a nomogram for predicting cancer-specific survival in patients with renal pelvic cancer following surgery
  122. Inhibition of ATG7 promotes orthodontic tooth movement by regulating the RANKL/OPG ratio under compression force
  123. A machine learning-based prognostic model integrating mRNA stemness index, hypoxia, and glycolysis‑related biomarkers for colorectal cancer
  124. Glutathione attenuates sepsis-associated encephalopathy via dual modulation of NF-κB and PKA/CREB pathways
  125. FAHD1 prevents neuronal ferroptosis by modulating R-loop and the cGAS–STING pathway
  126. Association of placenta weight and morphology with term low birth weight: A case–control study
  127. Investigation of the pathogenic variants induced Sjogren’s syndrome in Turkish population
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  130. Ultrasound-guided unilateral versus bilateral erector spinae plane block for postoperative analgesia of patients undergoing laparoscopic cholecystectomy
  131. Profiling gut microbiome dynamics in subacute thyroiditis: Implications for pathogenesis, diagnosis, and treatment
  132. Delta neutrophil index, CRP/albumin ratio, procalcitonin, immature granulocytes, and HALP score in acute appendicitis: Best performing biomarker?
  133. Anticancer activity mechanism of novelly synthesized and characterized benzofuran ring-linked 3-nitrophenyl chalcone derivative on colon cancer cells
  134. H2valdien3 arrests the cell cycle and induces apoptosis of gastric cancer
  135. Prognostic relevance of PRSS2 and its immune correlates in papillary thyroid carcinoma
  136. Association of SGLT2 inhibition with psychiatric disorders: A Mendelian randomization study
  137. Motivational interviewing for alcohol use reduction in Thai patients
  138. Luteolin alleviates oxygen-glucose deprivation/reoxygenation-induced neuron injury by regulating NLRP3/IL-1β signaling
  139. Polyphyllin II inhibits thyroid cancer cell growth by simultaneously inhibiting glycolysis and oxidative phosphorylation
  140. Relationship between the expression of copper death promoting factor SLC31A1 in papillary thyroid carcinoma and clinicopathological indicators and prognosis
  141. CSF2 polarized neutrophils and invaded renal cancer cells in vitro influence
  142. Proton pump inhibitors-induced thrombocytopenia: A systematic literature analysis of case reports
  143. The current status and influence factors of research ability among community nurses: A sequential qualitative–quantitative study
  144. OKAIN: A comprehensive oncology knowledge base for the interpretation of clinically actionable alterations
  145. The relationship between serum CA50, CA242, and SAA levels and clinical pathological characteristics and prognosis in patients with pancreatic cancer
  146. Identification and external validation of a prognostic signature based on hypoxia–glycolysis-related genes for kidney renal clear cell carcinoma
  147. Engineered RBC-derived nanovesicles functionalized with tumor-targeting ligands: A comparative study on breast cancer targeting efficiency and biocompatibility
  148. Relationship of resting echocardiography combined with serum micronutrients to the severity of low-gradient severe aortic stenosis
  149. Effect of vibration on pain during subcutaneous heparin injection: A randomized, single-blind, placebo-controlled trial
  150. The diagnostic performance of machine learning-based FFRCT for coronary artery disease: A meta-analysis
  151. Comparing biofeedback device vs diaphragmatic breathing for bloating relief: A randomized controlled trial
  152. Serum uric acid to albumin ratio and C-reactive protein as predictive biomarkers for chronic total occlusion and coronary collateral circulation quality
  153. Multiple organ scoring systems for predicting in-hospital mortality of sepsis patients in the intensive care unit
  154. Single-cell RNA sequencing data analysis of the inner ear in gentamicin-treated mice via intraperitoneal injection
  155. Suppression of cathepsin B attenuates myocardial injury via limiting cardiomyocyte apoptosis
  156. Influence of sevoflurane combined with propofol anesthesia on the anesthesia effect and adverse reactions in children with acute appendicitis
  157. Identification of hub genes related to acute kidney injury caused by sevoflurane anesthesia and endoplasmic reticulum stress
  158. Efficacy and safety of PD-1/PD-L1 inhibitors in pancreatic ductal adenocarcinoma: a systematic review and Meta-analysis of randomized controlled trials
  159. The value of diagnostic experience in O-RADS MRI score for ovarian-adnexal lesions
  160. Health education pathway for individuals with temporary enterostomies using patient journey mapping
  161. Serum TLR8 as a potential diagnostic biomarker of coronary heart disease
  162. Intraoperative temperature management and its effect on surgical outcomes in elderly patients undergoing lichtenstein unilateral inguinal hernia repair
  163. Immunohistochemical profiling and neuroepithelial heterogeneity in immature ovarian teratomas: a retrospective digital pathology-based study
  164. Associated risk factors and prevalence of human papillomavirus infection among females visiting tertiary care hospital: a cross-sectional study from Nepal
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  173. Impact of combined diaphragm-lung ultrasound assessment on postoperative respiratory function in patients under general anesthesia recovery
  174. Development and internal validation of a nomogram for predicting short-term prognosis in ICU patients with acute pyelonephritis
  175. The association between hypoxic burden and blood pressure in patients with obstructive sleep apnea
  176. Promotion of asthenozoospermia by C9orf72 through suppression of spermatogonia activity via fructose metabolism and mitophagy
  177. Review Articles
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  179. Diabetes-related cognitive impairment: Mechanisms, symptoms, and treatments
  180. Microscopic changes and gross morphology of placenta in women affected by gestational diabetes mellitus in dietary treatment: A systematic review
  181. Review of mechanisms and frontier applications in IL-17A-induced hypertension
  182. Research progress on the correlation between islet amyloid peptides and type 2 diabetes mellitus
  183. The safety and efficacy of BCG combined with mitomycin C compared with BCG monotherapy in patients with non-muscle-invasive bladder cancer: A systematic review and meta-analysis
  184. The application of augmented reality in robotic general surgery: A mini-review
  185. The effect of Greek mountain tea extract and wheat germ extract on peripheral blood flow and eicosanoid metabolism in mammals
  186. Neurogasobiology of migraine: Carbon monoxide, hydrogen sulfide, and nitric oxide as emerging pathophysiological trinacrium relevant to nociception regulation
  187. Plant polyphenols, terpenes, and terpenoids in oral health
  188. Laboratory medicine between technological innovation, rights safeguarding, and patient safety: A bioethical perspective
  189. End-of-life in cancer patients: Medicolegal implications and ethical challenges in Europe
  190. The maternal factors during pregnancy for intrauterine growth retardation: An umbrella review
  191. Intra-abdominal hypertension/abdominal compartment syndrome of pediatric patients in critical care settings
  192. PI3K/Akt pathway and neuroinflammation in sepsis-associated encephalopathy
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  194. Giant borderline ovarian tumours – review of the literature
  195. Leveraging artificial intelligence for collaborative care planning: Innovations and impacts in shared decision-making – A systematic review
  196. Cholera epidemiology analysis through the experience of the 1973 Naples epidemic
  197. Risk factors of frailty/sarcopenia in community older adults: Meta-analysis
  198. Supplement strategies for infertility in overweight women: Evidence and legal insights
  199. Scurvy, a not obsolete disorder: Clinical report in eight young children and literature review
  200. A meta-analysis of the effects of DBS on cognitive function in patients with advanced PD
  201. Protective role of selenium in sepsis: Mechanisms and potential therapeutic strategies
  202. Strategies for hyperkalemia management in dialysis patients: A systematic review
  203. C-reactive protein-to-albumin ratio in peripheral artery disease
  204. Research progress on autophagy and its roles in sepsis induced organ injury
  205. Neuronutrition in autism spectrum disorders
  206. Pumilio 2 in neural development, function, and specific neurological disorders
  207. Antibiotic prescribing patterns in general dental practice- a scoping review
  208. Clinical and medico-legal reflections on non-invasive prenatal testing
  209. Smartphone use and back pain: a narrative review of postural pathologies
  210. Targeting endothelial oxidative stress in hypertension
  211. Exploring links between acne and metabolic syndrome: a narrative review
  212. Case Reports
  213. Delayed graft function after renal transplantation
  214. Semaglutide treatment for type 2 diabetes in a patient with chronic myeloid leukemia: A case report and review of the literature
  215. Diverse electrophysiological demyelinating features in a late-onset glycogen storage disease type IIIa case
  216. Giant right atrial hemangioma presenting with ascites: A case report
  217. Laser excision of a large granular cell tumor of the vocal cord with subglottic extension: A case report
  218. EsoFLIP-assisted dilation for dysphagia in systemic sclerosis: Highlighting the role of multimodal esophageal evaluation
  219. Molecular hydrogen-rhodiola as an adjuvant therapy for ischemic stroke in internal carotid artery occlusion: A case report
  220. Coronary artery anomalies: A case of the “malignant” left coronary artery and its surgical management
  221. Combined VAT and retroperitoneoscopy for pleural empyema due to nephro-pleuric fistula in xanthogranulomatous pyelonephritis
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  223. Newly diagnosed B-cell acute lymphoblastic leukemia demonstrating localized bone marrow infiltration exclusively in the lower extremities
  224. Rapid Communication
  225. Biological properties of valve materials using RGD and EC
  226. A single oral administration of flavanols enhances short-term memory in mice along with increased brain-derived neurotrophic factor
  227. Repeat influenza incidence across two consecutive influenza seasons
  228. Letter to the Editor
  229. Role of enhanced external counterpulsation in long COVID
  230. Expression of Concern
  231. Expression of concern “A ceRNA network mediated by LINC00475 in papillary thyroid carcinoma”
  232. Expression of concern “Notoginsenoside R1 alleviates spinal cord injury through the miR-301a/KLF7 axis to activate Wnt/β-catenin pathway”
  233. Expression of concern “circ_0020123 promotes cell proliferation and migration in lung adenocarcinoma via PDZD8”
  234. Corrigendum
  235. Corrigendum to “Empagliflozin improves aortic injury in obese mice by regulating fatty acid metabolism”
  236. Corrigendum to “Comparing the therapeutic efficacy of endoscopic minimally invasive surgery and traditional surgery for early-stage breast cancer: A meta-analysis”
  237. Corrigendum to “The progress of autoimmune hepatitis research and future challenges”
  238. Retraction
  239. Retraction of “miR-654-5p promotes gastric cancer progression via the GPRIN1/NF-κB pathway”
  240. Retraction of: “LncRNA CASC15 inhibition relieves renal fibrosis in diabetic nephropathy through downregulating SP-A by sponging to miR-424”
  241. Retraction of: “SCARA5 inhibits oral squamous cell carcinoma via inactivating the STAT3 and PI3K/AKT signaling pathways”
  242. Special Issue Advancements in oncology: bridging clinical and experimental research - Part II
  243. Unveiling novel biomarkers for platinum chemoresistance in ovarian cancer
  244. Lathyrol affects the expression of AR and PSA and inhibits the malignant behavior of RCC cells
  245. The era of increasing cancer survivorship: Trends in fertility preservation, medico-legal implications, and ethical challenges
  246. Bone scintigraphy and positron emission tomography in the early diagnosis of MRONJ
  247. Meta-analysis of clinical efficacy and safety of immunotherapy combined with chemotherapy in non-small cell lung cancer
  248. Special Issue Computational Intelligence Methodologies Meets Recurrent Cancers - Part IV
  249. Exploration of mRNA-modifying METTL3 oncogene as momentous prognostic biomarker responsible for colorectal cancer development
  250. Special Issue The evolving saga of RNAs from bench to bedside - Part III
  251. Interaction and verification of ferroptosis-related RNAs Rela and Stat3 in promoting sepsis-associated acute kidney injury
  252. The mRNA MOXD1: Link to oxidative stress and prognostic significance in gastric cancer
  253. Special Issue Exploring the biological mechanism of human diseases based on MultiOmics Technology - Part II
  254. Dynamic changes in lactate-related genes in microglia and their role in immune cell interactions after ischemic stroke
  255. A prognostic model correlated with fatty acid metabolism in Ewing’s sarcoma based on bioinformatics analysis
  256. Red cell distribution width predicts early kidney injury: A NHANES cross-sectional study
  257. Special Issue Diabetes mellitus: pathophysiology, complications & treatment
  258. Nutritional risk assessment and nutritional support in children with congenital diabetes during surgery
  259. Correlation of the differential expressions of RANK, RANKL, and OPG with obesity in the elderly population in Xinjiang
  260. A discussion on the application of fluorescence micro-optical sectioning tomography in the research of cognitive dysfunction in diabetes
  261. A review of brain research on T2DM-related cognitive dysfunction
  262. Metformin and estrogen modulation in LABC with T2DM: A 36-month randomized trial
  263. Special Issue Innovative Biomarker Discovery and Precision Medicine in Cancer Diagnostics
  264. CircASH1L-mediated tumor progression in triple-negative breast cancer: PI3K/AKT pathway mechanisms
https://doi.org/10.1515/med-2025-1362
Keywords for this article
Opalski syndrome; lateral medullary syndrome; multiple sclerosis; non-vascular etiology; case report
Creative Commons
BY 4.0

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  4. Knockdown of CCNB1 alleviates high glucose-triggered trophoblast dysfunction during gestational diabetes via Wnt/β-catenin signaling pathway
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  18. Transcription factor A, mitochondrial promotes lymph node metastasis and lymphangiogenesis in epithelial ovarian carcinoma
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  25. Mechanism research on inhibition of gastric cancer in vitro by the extract of Pinellia ternata based on network pharmacology and cellular metabolomics
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  27. Clinical analysis of ten cases of HIV infection combined with acute leukemia
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  118. Petunidin attenuates lipopolysaccharide-induced retinal microglia inflammatory response in diabetic retinopathy by targeting OGT/NF-κB/LCN2 axis
  119. Procalcitonin and C-reactive protein as biomarkers for diagnosing and assessing the severity of acute cholecystitis
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  125. FAHD1 prevents neuronal ferroptosis by modulating R-loop and the cGAS–STING pathway
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  127. Investigation of the pathogenic variants induced Sjogren’s syndrome in Turkish population
  128. Nucleotide metabolic abnormalities in post-COVID-19 condition and type 2 diabetes mellitus patients and their association with endocrine dysfunction
  129. TGF-β–Smad2/3 signaling in high-altitude pulmonary hypertension in rats: Role and mechanisms via macrophage M2 polarization
  130. Ultrasound-guided unilateral versus bilateral erector spinae plane block for postoperative analgesia of patients undergoing laparoscopic cholecystectomy
  131. Profiling gut microbiome dynamics in subacute thyroiditis: Implications for pathogenesis, diagnosis, and treatment
  132. Delta neutrophil index, CRP/albumin ratio, procalcitonin, immature granulocytes, and HALP score in acute appendicitis: Best performing biomarker?
  133. Anticancer activity mechanism of novelly synthesized and characterized benzofuran ring-linked 3-nitrophenyl chalcone derivative on colon cancer cells
  134. H2valdien3 arrests the cell cycle and induces apoptosis of gastric cancer
  135. Prognostic relevance of PRSS2 and its immune correlates in papillary thyroid carcinoma
  136. Association of SGLT2 inhibition with psychiatric disorders: A Mendelian randomization study
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  138. Luteolin alleviates oxygen-glucose deprivation/reoxygenation-induced neuron injury by regulating NLRP3/IL-1β signaling
  139. Polyphyllin II inhibits thyroid cancer cell growth by simultaneously inhibiting glycolysis and oxidative phosphorylation
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  141. CSF2 polarized neutrophils and invaded renal cancer cells in vitro influence
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  144. OKAIN: A comprehensive oncology knowledge base for the interpretation of clinically actionable alterations
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  146. Identification and external validation of a prognostic signature based on hypoxia–glycolysis-related genes for kidney renal clear cell carcinoma
  147. Engineered RBC-derived nanovesicles functionalized with tumor-targeting ligands: A comparative study on breast cancer targeting efficiency and biocompatibility
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  149. Effect of vibration on pain during subcutaneous heparin injection: A randomized, single-blind, placebo-controlled trial
  150. The diagnostic performance of machine learning-based FFRCT for coronary artery disease: A meta-analysis
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  152. Serum uric acid to albumin ratio and C-reactive protein as predictive biomarkers for chronic total occlusion and coronary collateral circulation quality
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  154. Single-cell RNA sequencing data analysis of the inner ear in gentamicin-treated mice via intraperitoneal injection
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  156. Influence of sevoflurane combined with propofol anesthesia on the anesthesia effect and adverse reactions in children with acute appendicitis
  157. Identification of hub genes related to acute kidney injury caused by sevoflurane anesthesia and endoplasmic reticulum stress
  158. Efficacy and safety of PD-1/PD-L1 inhibitors in pancreatic ductal adenocarcinoma: a systematic review and Meta-analysis of randomized controlled trials
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  161. Serum TLR8 as a potential diagnostic biomarker of coronary heart disease
  162. Intraoperative temperature management and its effect on surgical outcomes in elderly patients undergoing lichtenstein unilateral inguinal hernia repair
  163. Immunohistochemical profiling and neuroepithelial heterogeneity in immature ovarian teratomas: a retrospective digital pathology-based study
  164. Associated risk factors and prevalence of human papillomavirus infection among females visiting tertiary care hospital: a cross-sectional study from Nepal
  165. Comparative evaluation of various disc elution methods for the detection of colistin-resistant gram-negative bacteria
  166. Effect of timing of cholecystectomy on weight loss after sleeve gastrectomy in morbidly obese individuals with cholelithiasis: a retrospective cohort study
  167. Causal association between ceramide levels and central precocious puberty: a mendelian randomization study
  168. Novel predictive model for colorectal liver metastases recurrence: a radiomics and clinical data approach
  169. Relationship between resident physicians’ perceived professional value and exposure to violence
  170. Multiple sclerosis and type 1 diabetes: a Mendelian randomization study of European ancestry
  171. Rapid pathogen identification in peritoneal dialysis effluent by MALDI-TOF MS following blood culture enrichment
  172. Comparison of open and percutaneous A1 pulley release in pediatric trigger thumb: a retrospective cohort study
  173. Impact of combined diaphragm-lung ultrasound assessment on postoperative respiratory function in patients under general anesthesia recovery
  174. Development and internal validation of a nomogram for predicting short-term prognosis in ICU patients with acute pyelonephritis
  175. The association between hypoxic burden and blood pressure in patients with obstructive sleep apnea
  176. Promotion of asthenozoospermia by C9orf72 through suppression of spermatogonia activity via fructose metabolism and mitophagy
  177. Review Articles
  178. The effects of enhanced external counter-pulsation on post-acute sequelae of COVID-19: A narrative review
  179. Diabetes-related cognitive impairment: Mechanisms, symptoms, and treatments
  180. Microscopic changes and gross morphology of placenta in women affected by gestational diabetes mellitus in dietary treatment: A systematic review
  181. Review of mechanisms and frontier applications in IL-17A-induced hypertension
  182. Research progress on the correlation between islet amyloid peptides and type 2 diabetes mellitus
  183. The safety and efficacy of BCG combined with mitomycin C compared with BCG monotherapy in patients with non-muscle-invasive bladder cancer: A systematic review and meta-analysis
  184. The application of augmented reality in robotic general surgery: A mini-review
  185. The effect of Greek mountain tea extract and wheat germ extract on peripheral blood flow and eicosanoid metabolism in mammals
  186. Neurogasobiology of migraine: Carbon monoxide, hydrogen sulfide, and nitric oxide as emerging pathophysiological trinacrium relevant to nociception regulation
  187. Plant polyphenols, terpenes, and terpenoids in oral health
  188. Laboratory medicine between technological innovation, rights safeguarding, and patient safety: A bioethical perspective
  189. End-of-life in cancer patients: Medicolegal implications and ethical challenges in Europe
  190. The maternal factors during pregnancy for intrauterine growth retardation: An umbrella review
  191. Intra-abdominal hypertension/abdominal compartment syndrome of pediatric patients in critical care settings
  192. PI3K/Akt pathway and neuroinflammation in sepsis-associated encephalopathy
  193. Screening of Group B Streptococcus in pregnancy: A systematic review for the laboratory detection
  194. Giant borderline ovarian tumours – review of the literature
  195. Leveraging artificial intelligence for collaborative care planning: Innovations and impacts in shared decision-making – A systematic review
  196. Cholera epidemiology analysis through the experience of the 1973 Naples epidemic
  197. Risk factors of frailty/sarcopenia in community older adults: Meta-analysis
  198. Supplement strategies for infertility in overweight women: Evidence and legal insights
  199. Scurvy, a not obsolete disorder: Clinical report in eight young children and literature review
  200. A meta-analysis of the effects of DBS on cognitive function in patients with advanced PD
  201. Protective role of selenium in sepsis: Mechanisms and potential therapeutic strategies
  202. Strategies for hyperkalemia management in dialysis patients: A systematic review
  203. C-reactive protein-to-albumin ratio in peripheral artery disease
  204. Research progress on autophagy and its roles in sepsis induced organ injury
  205. Neuronutrition in autism spectrum disorders
  206. Pumilio 2 in neural development, function, and specific neurological disorders
  207. Antibiotic prescribing patterns in general dental practice- a scoping review
  208. Clinical and medico-legal reflections on non-invasive prenatal testing
  209. Smartphone use and back pain: a narrative review of postural pathologies
  210. Targeting endothelial oxidative stress in hypertension
  211. Exploring links between acne and metabolic syndrome: a narrative review
  212. Case Reports
  213. Delayed graft function after renal transplantation
  214. Semaglutide treatment for type 2 diabetes in a patient with chronic myeloid leukemia: A case report and review of the literature
  215. Diverse electrophysiological demyelinating features in a late-onset glycogen storage disease type IIIa case
  216. Giant right atrial hemangioma presenting with ascites: A case report
  217. Laser excision of a large granular cell tumor of the vocal cord with subglottic extension: A case report
  218. EsoFLIP-assisted dilation for dysphagia in systemic sclerosis: Highlighting the role of multimodal esophageal evaluation
  219. Molecular hydrogen-rhodiola as an adjuvant therapy for ischemic stroke in internal carotid artery occlusion: A case report
  220. Coronary artery anomalies: A case of the “malignant” left coronary artery and its surgical management
  221. Combined VAT and retroperitoneoscopy for pleural empyema due to nephro-pleuric fistula in xanthogranulomatous pyelonephritis
  222. A rare case of Opalski syndrome with a suspected multiple sclerosis etiology
  223. Newly diagnosed B-cell acute lymphoblastic leukemia demonstrating localized bone marrow infiltration exclusively in the lower extremities
  224. Rapid Communication
  225. Biological properties of valve materials using RGD and EC
  226. A single oral administration of flavanols enhances short-term memory in mice along with increased brain-derived neurotrophic factor
  227. Repeat influenza incidence across two consecutive influenza seasons
  228. Letter to the Editor
  229. Role of enhanced external counterpulsation in long COVID
  230. Expression of Concern
  231. Expression of concern “A ceRNA network mediated by LINC00475 in papillary thyroid carcinoma”
  232. Expression of concern “Notoginsenoside R1 alleviates spinal cord injury through the miR-301a/KLF7 axis to activate Wnt/β-catenin pathway”
  233. Expression of concern “circ_0020123 promotes cell proliferation and migration in lung adenocarcinoma via PDZD8”
  234. Corrigendum
  235. Corrigendum to “Empagliflozin improves aortic injury in obese mice by regulating fatty acid metabolism”
  236. Corrigendum to “Comparing the therapeutic efficacy of endoscopic minimally invasive surgery and traditional surgery for early-stage breast cancer: A meta-analysis”
  237. Corrigendum to “The progress of autoimmune hepatitis research and future challenges”
  238. Retraction
  239. Retraction of “miR-654-5p promotes gastric cancer progression via the GPRIN1/NF-κB pathway”
  240. Retraction of: “LncRNA CASC15 inhibition relieves renal fibrosis in diabetic nephropathy through downregulating SP-A by sponging to miR-424”
  241. Retraction of: “SCARA5 inhibits oral squamous cell carcinoma via inactivating the STAT3 and PI3K/AKT signaling pathways”
  242. Special Issue Advancements in oncology: bridging clinical and experimental research - Part II
  243. Unveiling novel biomarkers for platinum chemoresistance in ovarian cancer
  244. Lathyrol affects the expression of AR and PSA and inhibits the malignant behavior of RCC cells
  245. The era of increasing cancer survivorship: Trends in fertility preservation, medico-legal implications, and ethical challenges
  246. Bone scintigraphy and positron emission tomography in the early diagnosis of MRONJ
  247. Meta-analysis of clinical efficacy and safety of immunotherapy combined with chemotherapy in non-small cell lung cancer
  248. Special Issue Computational Intelligence Methodologies Meets Recurrent Cancers - Part IV
  249. Exploration of mRNA-modifying METTL3 oncogene as momentous prognostic biomarker responsible for colorectal cancer development
  250. Special Issue The evolving saga of RNAs from bench to bedside - Part III
  251. Interaction and verification of ferroptosis-related RNAs Rela and Stat3 in promoting sepsis-associated acute kidney injury
  252. The mRNA MOXD1: Link to oxidative stress and prognostic significance in gastric cancer
  253. Special Issue Exploring the biological mechanism of human diseases based on MultiOmics Technology - Part II
  254. Dynamic changes in lactate-related genes in microglia and their role in immune cell interactions after ischemic stroke
  255. A prognostic model correlated with fatty acid metabolism in Ewing’s sarcoma based on bioinformatics analysis
  256. Red cell distribution width predicts early kidney injury: A NHANES cross-sectional study
  257. Special Issue Diabetes mellitus: pathophysiology, complications & treatment
  258. Nutritional risk assessment and nutritional support in children with congenital diabetes during surgery
  259. Correlation of the differential expressions of RANK, RANKL, and OPG with obesity in the elderly population in Xinjiang
  260. A discussion on the application of fluorescence micro-optical sectioning tomography in the research of cognitive dysfunction in diabetes
  261. A review of brain research on T2DM-related cognitive dysfunction
  262. Metformin and estrogen modulation in LABC with T2DM: A 36-month randomized trial
  263. Special Issue Innovative Biomarker Discovery and Precision Medicine in Cancer Diagnostics
  264. CircASH1L-mediated tumor progression in triple-negative breast cancer: PI3K/AKT pathway mechanisms
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