Neuroanatomy basics · USMLE Step 1

A patient presents with loss of pain and temperature sensation on the right side of the body below the neck, along with left-sided facial pain loss. Which structure is most likely damaged?

  1. Left lateral spinothalamic tract
  2. Right lateral spinothalamic tract
  3. Left medial lemniscus
  4. Right corticospinal tract
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Correct answer: Left lateral spinothalamic tract

Loss of contralateral body pain and ipsilateral facial pain suggests a lesion in the lateral medulla affecting the spinothalamic tract. This is characteristic of a lateral medullary (Wallenberg) syndrome.

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