Ischemia of brain tissue and the tracts passing through the medulla manifest with various symptoms, most commonly ataxia, nystagmus, voice changes, dysphagia and sensory deficits. Some people may experience a symptomatic decrease in the space of a few months or even weeks. The lateral medullary syndrome may be total or partial depending on the involvement of vessels supplying lateral medulla. Oxygenated blood doesnt get to this part of the brain when the arteries that lead to it are blocked. It is most often secondary to intracranial vertebral artery or posterior inferior cerebellar artery occlusion due to atherothrombosis or embolism and sometimes due to spontaneous dissection of the vertebral arteries. Lateral medullary syndrome online neuroanatomy lecture. Signs and symptoms may include swallowing difficulties, dizziness, hoarseness, nausea and vomiting, nystagmus, and problems with balance. Lateral medullary syndrome an overview sciencedirect topics. Lateral medullary syndrome after prone position for general. Wallenberg syndrome is a rare condition in which an infarction, or stroke, occurs in the lateral medulla. Feb 10, 2011 facial pain may be a feature of wallenbergs lateral medullary syndrome, along with a decrease of pain and temperature sensation of the face. Wallenbergs syndrome and symptomatic trigeminal neuralgia. According to the national institute of neurological disorders and stroke, wallenberg syndrome aka lateral medullary syndrome or posterior inferior cerebellar artery syndrome is a neurological condition caused by a blockage of the vertebral artery va or posterior inferior cerebellar artery pica, ultimately leading to infarction of the. I have earlier had hypertension for 15yrs and also been found about a year ago with rbbb.
Lateral medullary syndrome, also known as posterior inferior cerebellar artery syndrome, or wallenbergs syndrome, is one of the best recognized among the several syndromes of brainstem strokes. Lateral medullary syndrome aka wallenberg syndrome and posterior inferior cerebellar artery syndrome pica is a disease in which the patient has a constellation of neurologic symptoms due to injury to the lateral part of the medulla in the brain, resulting in tissue ischemia and necrosis. Lateral medullary syndrome, case report journal of universal dec 30, 2016. The functional outcome and degree of disability of patients with lmi, however, have not been as well investigated. The most common cause is a lateral medullary infarction, which produces a horner syndrome as part of the wallenberg syndrome. The case study is aimed at providing a more thorough analysis of a case of lateral medullary syndrome presented only with persistent hiccup after eating lunch the study hopes to generate an interest for further studies into the topic and focuses on abnorm\ al unusual presentations of lateral medullary syndrome. Wallenberg syndrome pica syndrome or lateral medullary infaction sensory deficits affecting the face and cranial nerves on the same side with the infarct. A provisional diagnosis of a left medullary lesion secondary to vertebral artery dissection was made given the lack of typical stroke risk factors and the history of recent spinal manipulation.
The medulla oblongata regulates vital characteristics of the body, such as blood pressure, heartbeat, breathing, sleep cycles, and digestion. The clinical picture was suggestive of lateral medullary syndrome lms. The present treatment includes pentocid, depin retard, concor 5, asa 50, carvideon. Wallenberg syndrome lateral medullary syndrome aka pica syndrome posterior inferior cerebellar artery syndrome constellation of neurologic symptoms due to injury to the lateral part of the medulla in the brain. Recovery following lateral medullary infarction neurology. Wallenberg syndrome pica syndrome lateral medullary infarction. Wallenbergs syndrome, also called lateral medullary syndrome or wallenberg syndrome, is a neurological condition that can develop when damage occurs in a part of the brainstem called the lateral. Lateral medullary syndrome an overview sciencedirect. Mar 11, 2020 prognosis for lateral medullary syndrome varies from patient to patient.
Wallenberg syndrome or lateral medullary infarction, is associated with the acute onset of vertigo and disequilibrium. This means that lateral medullary syndrome, or a subtype of lateral medullary syndrome, affects less than 200,000 people in the us population. Differentials included embolic phenomena and tumor. I am 64 years old and had a nonhemorrhagic infarction in the left half of medulla on 2 months ago. Medial medullary syndrome, also known as inferior alternating syndrome, hypoglossal alternating hemiplegia, lower alternating hemiplegia, or dejerine syndrome, is a type of alternating hemiplegia characterized by a set of clinical features resulting from occlusion of the anterior spinal artery. This is most commonly due to occlusion of the intracranial portion of the vertebral artery followed by pica and its branches. Case report on hiccup and lateral medullary syndrome.
Lateral medullary syndrome video lecture made simple. Lateral medullary infarctions lateral medullary syndrome comprise approximately 2% of ischemic stroke 1. Posterior inferior cerebellar artery lateral medullary syndrome wallenberg syndrome. Wallenbergs syndrome information page national institute. Nov 07, 2014 lateral medullary syndrome also called wallenberg syndrome and posterior inferior cerebellar artery syndrome is a disorder in which the patient has a constellation of neurologic symptoms due to.
Others, however, are not so lucky, as the neurological problems they contracted from lateral medullary syndrome may remain with them for the rest of their lives. Wallenbergs lateral medullary syndrome contributed by thalia field and jason barton, university of british columbia, march 2010 etiology. Lateral medullary syndrome is also called wallenbergs syndrome, posterior inferior cerebellar artery syndrome and vertebral artery syndrome. Wallenberg syndrome lateral medullary syndrome cerebral infarction or hemorrhage stroke in the medulla in the brainstem, has been named specifically as the syndrome of wallenberg or wallenberg syndrome. Most of her findings were consistent with lateral medullary syndrome, but she had some pontine involvement, and some features of medial medullary syndrome. Lateral medullary other infarction brainstem alone infarction normal lateral medullary syndrome only 3 3 1 plus facial weakness, diplopia, or blurred vision 9 5 1 mri indicates magnetic resonance imaging. Symptoms include difficulties with swallowing, hoarseness, dizziness, nausea and vomiting, rapid involuntary movements of the eyes nystagmus, and problems with balance and gait coordination. The most common underlying cause of wallenberg syndrome is a brain stem stroke in the vertebral or posterior inferior cerebellar arteries of the brain stem. Lateral medullary infarction lmi has a welldefined clinical syndrome and vascular pathology. However, several other disorders or conditions reportedly have been associated with wallenberg syndrome, including. Lateral medullary syndrome wallenberg syndrome internet. This is most commonly due to occlusion of the intracranial portion of the vertebral artery.
Third nerve fibers andor third nerve nucleus on side opposite lesion hemiataxia. Wallenberg syndrome genetic and rare diseases information. Typically, the patient presents with vertigo and ataxia. Ibrahim mollah, 50 years old male person, non diabetic, non hypertensive but smoker presented with. Mechanical trauma to the vertebral artery in the neck.
Structures affected in lateral medullary syndrome a transverse view of nuclei affected in the left lateral medullary. Wallenbergs syndrome is a neurological condition caused by a stroke in the vertebral or posterior inferior cerebellar artery of the brain stem. It was named after adolf wallenberg 18621949, who was a renowned jewish neurologist and neuroanatomist who practiced in germany. May 22, 2017 wallenberg syndrome is a condition that affects the nervous system. There are some neurological symptoms as a result of damage to the following areas. Lateral medullary syndrome postchiropractic manipulation in. It led to lateral medullary syndrome with associated problems including temperature insensitivity on the right side. She was shaky and sweaty, raising the possibility of pheochromocytoma. The lateral medullary syndrome is not a very common stroke. Some people have uncontrollable hiccups, loss of pain and temperature sensation on one side of the face, andor weakness or numbness on one. Wallenberg syndrome pica syndrome lateral medullary. Lateral medullary syndrome wallenberg syndrome prof. We followed 18 consecutive patients with lmi during inpatient stroke rehabilitation. Medial medullary syndrome an overview sciencedirect topics.
Lateral medullary syndrome radiology reference article. Lateral medullary syndrome definition of lateral medullary. Lateral medullary syndrome is due to infarction in the lateral part of the medulla. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Occlusion of the posterior inferior cerebellar artery pica causes the lateral medullary syndrome and infarction of lateral medulla. Lateral medullary syndrome is listed as a rare disease by the office of rare diseases ord of the national institutes of health nih.
Other clinical features include vertigo, eye movement disorders, an ipsilateral horners syndrome, ipsilateral limb ataxia, and contralateral sensory deficit. This is the result of a vascular lesion that involves either the vertebral artery andor the posterior inferior cerebellar artery which is known by its acronym, pica. The most common stroke of the vestibular system, first reported in the late 19th century, 31 is lateral medullary syndrome, also known as wallenberg syndrome. The diagnosis is made clinically and with the help of magnetic resonance imaging. Mar 16, 20 lateral midbrain syndrome syndrome of small penetrating arteries arising from posterior cerebral artery on side of lesion eye down and out secondary to unopposed action of fourth and sixth cranial nerves, with dilated and unresponsive pupil. Wallenbergs lateral medullary syndromecanadian neuro. The ischemia is a result of a blockage most commonly in the vertebral artery or the posterior inferior cerebellar artery. Wallenbergs syndrome is a lateral medullary infarction that causes vertigo, ipsilateral paralysis of the soft palate, larynx, and pharynx, dysphonia, dysphagia, ipsilateral facial numbness and loss of corneal, reflexes, ipsilateral, horners syndrome, ipsilateral cerebellar asynergy, and hypotonia. Mar 12, 20 stroke syndromes and clinical management. The view that we have here is the medulla at the level of the olive. Sensory deficits affecting the trunk torso and extremities on the opposite side of the infarction. Lateral medullary syndrome lms, also called wallenberg syndrome or posterior inferior cerebellar artery syndrome results from a vascular event in the lateral part of the medulla oblongata.1187 234 240 1266 496 655 1346 1249 873 446 210 1088 944 322 1367 1118 612 1393 269 730 751 363 582 602 135 559 424 37 665 778 1025 979 1111 477