Case Report
Published: Nov 30, 2025 | DOI: 10.24911/ejmcr.9-2340
Opalski Syndrome with Ataxic Breathing in a Young Stroke Patient: A Rare Case Report
Authors: Aasim Ali , Labeeba Abdul Ghafoor , Muhammad Numan Akram , Muhammad Shahzeb , Mukesh Kumar Sharma , Usama Saleem , Muhammad Abdullah Mushtaq , Taha Mehmood ,
Article Info
Authors
Aasim Ali
Neurology Department, Allied Hospital Faisalabad, Faisalabad Medical University, Faisalabad, Pakistan
Labeeba Abdul Ghafoor
Neurology Department, Allied Hospital Faisalabad, Faisalabad Medical University, Faisalabad, Pakistan
Muhammad Numan Akram
Neurology Department, Allied Hospital Faisalabad, Faisalabad Medical University, Faisalabad, Pakistan
Muhammad Shahzeb
Neurology Department, Allied Hospital Faisalabad, Faisalabad Medical University, Faisalabad, Pakistan
Mukesh Kumar Sharma
Dhankuta District Hospital, Dhankuta, Nepal
Usama Saleem
Department of Internal Medicine, Allied Hospital Faisalabad, Faisalabad, Pakistan
Muhammad Abdullah Mushtaq
Department of Internal Medicine, Allied Hospital Faisalabad, Faisalabad, Pakistan
Taha Mehmood
Department of Internal Medicine, Allied Hospital Faisalabad, Faisalabad, Pakistan
Publication History
Received: August 22, 2025
Accepted: October 31, 2025
Published: November 30, 2025
Abstract
Background: Opalski Syndrome is a rare variant of lateral medullary syndrome characterized by ipsilateral hemiparesis due to medullary infarction extending into the cervical spinal cord.
Case Presentation: A 30-year-old Asian male with newly diagnosed diabetes presented with vomiting, vertigo, dysphagia, ataxic breathing, and ipsilateral facial and contralateral sensory loss. Subsequently, he developed right-sided hemiplegia. He had an ataxic respiratory pattern suggesting medullary involvement. Magnetic resonance imaging brain and cervical spine Fluid-Attenuated Inversion Recovery (FLAIR) revealed an infarction in the right medulla extending into the ipsilateral spinal cord. Stroke workup for young patients yielded negative results. A computed tomography angiography brain was done to rule out vertebrobasilar
dissection. Workup for stroke in the young was unremarkable. In addition to anti-platelets and statin; frequent blood gas analysis was performed because of his abnormal breathing pattern. Tissue plasminogen activator was not administered as the patient presented late in our stroke center, and the initial NIHSS score was 4.
Conclusion: This case emphasizes that Opalski syndrome should be considered in young stroke patients presenting with lateral medullary features and ipsilateral hemiparesis. Recognition of ataxic breathing as a clinical clue to medullary involvement can guide timely diagnosis and management.
Keywords: Opalski Syndrome, medullary infarct, hemiplegia, brainstem stroke, stroke in young
Pubmed Style
Aasim Ali , Labeeba Abdul Ghafoor, Muhammad Numan Akram, Muhammad Shahzeb, Mukesh Kumar Sharma , Usama Saleem , Muhammad Abdullah Mushtaq, Taha Mehmood. Opalski Syndrome with Ataxic Breathing in a Young Stroke Patient: A Rare Case Report. EJMCR. 2025; 30 (November 2025): -. doi:10.24911/ejmcr.9-2340
Web Style
Aasim Ali , Labeeba Abdul Ghafoor, Muhammad Numan Akram, Muhammad Shahzeb, Mukesh Kumar Sharma , Usama Saleem , Muhammad Abdullah Mushtaq, Taha Mehmood. Opalski Syndrome with Ataxic Breathing in a Young Stroke Patient: A Rare Case Report. https://ejmcr.com/articles/2340 [Access: November 30, 2025]. doi:10.24911/ejmcr.9-2340
AMA (American Medical Association) Style
Aasim Ali , Labeeba Abdul Ghafoor, Muhammad Numan Akram, Muhammad Shahzeb, Mukesh Kumar Sharma , Usama Saleem , Muhammad Abdullah Mushtaq, Taha Mehmood. Opalski Syndrome with Ataxic Breathing in a Young Stroke Patient: A Rare Case Report. EJMCR. 2025; 30 (November 2025): -. doi:10.24911/ejmcr.9-2340
Vancouver/ICMJE Style
Aasim Ali , Labeeba Abdul Ghafoor, Muhammad Numan Akram, Muhammad Shahzeb, Mukesh Kumar Sharma , Usama Saleem , Muhammad Abdullah Mushtaq, Taha Mehmood. Opalski Syndrome with Ataxic Breathing in a Young Stroke Patient: A Rare Case Report. EJMCR. (2025), [cited November 30, 2025]; 30 (November 2025): -. doi:10.24911/ejmcr.9-2340
Harvard Style
Aasim Ali , Labeeba Abdul Ghafoor, Muhammad Numan Akram, Muhammad Shahzeb, Mukesh Kumar Sharma , Usama Saleem , Muhammad Abdullah Mushtaq, Taha Mehmood (2025) Opalski Syndrome with Ataxic Breathing in a Young Stroke Patient: A Rare Case Report. EJMCR, 30 (November 2025): -. doi:10.24911/ejmcr.9-2340
Chicago Style
Aasim Ali , Labeeba Abdul Ghafoor, Muhammad Numan Akram, Muhammad Shahzeb, Mukesh Kumar Sharma , Usama Saleem , Muhammad Abdullah Mushtaq, Taha Mehmood. "Opalski Syndrome with Ataxic Breathing in a Young Stroke Patient: A Rare Case Report." 30 (2025), -. doi:10.24911/ejmcr.9-2340
MLA (The Modern Language Association) Style
Aasim Ali , Labeeba Abdul Ghafoor, Muhammad Numan Akram, Muhammad Shahzeb, Mukesh Kumar Sharma , Usama Saleem , Muhammad Abdullah Mushtaq, Taha Mehmood. "Opalski Syndrome with Ataxic Breathing in a Young Stroke Patient: A Rare Case Report." 30.November 2025 (2025), -. Print. doi:10.24911/ejmcr.9-2340
APA (American Psychological Association) Style
Aasim Ali , Labeeba Abdul Ghafoor, Muhammad Numan Akram, Muhammad Shahzeb, Mukesh Kumar Sharma , Usama Saleem , Muhammad Abdullah Mushtaq, Taha Mehmood (2025) Opalski Syndrome with Ataxic Breathing in a Young Stroke Patient: A Rare Case Report. , 30 (November 2025), -. doi:10.24911/ejmcr.9-2340