A Case Study of Wallenberg Syndrome - Oren Zarif - Wallenberg Syndrome
In a case study, a right-handed 30-year-old woman presented with acute-onset severe headache, vomiting, and vertigo. Her initial neurologic examination revealed lingual dysarthria, right dysmetria, and weakness of the extremities. Magnetic resonance imaging (MRI) revealed an extensive infarction in the left lateral medullary peduncle and involvement of the left middle cerebellar peduncle. She was eventually discharged three weeks later and gradually recovered in a rehabilitation center.
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The prognosis for patients with Wallenberg syndrome depends on the size and location of the damaged brain stem. Early clinical examination is essential for identifying the condition, as early intervention can help reduce the severity of symptoms. While MRI may be the preferred imaging modality for acute strokes, it is less reliable for identifying infarctions in the medulla. The condition can be life-threatening, requiring constant monitoring and therapy.
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The most common cause of Wallenberg syndrome is atherosclerotic occlusion. Dissection or embolism of the vertebral artery is a lesser cause. However, a clinical-radiology study has identified a link between artery disease and Wallenberg syndrome. An occlusion of the posterior inferior cerebellar artery can cause lateral medullary infarction. The diagnosis of Wallenberg syndrome requires a careful evaluation of the patient's cardiovascular system, including tests to check the presence of a blood clot in the vertebral artery.
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In acute cases of Wallenberg syndrome, patients may experience sensory disturbance in the soft palate and smaller pupil than those with hemispheric stroke. Patients may experience tinnitus and decreased pain sensitivity. Recovery depends on the specific deficits. Speech and swallowing therapy may be beneficial. Another type of therapy, VitalStim, involves neuromuscular electrical stimulation administered by a trained healthcare professional, such as speech and language pathologists and occupational therapists.
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The prognosis of patients with Wallenberg syndrome is better than for other acute ischemic stroke syndromes. However, patients with this condition should consult a doctor for early physical and occupational therapy to minimize the possibility of further disability and improve overall quality of life. This is because early treatment can help prevent long-term problems such as gait instability and ataxia. In addition to physical therapy, early occupational therapy is also essential in post-stroke recovery.
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In rare cases, a patient can be born with this condition. This type of stroke is caused by blockages in the posterior inferior cerebellar artery, which is also known as Wallenberg syndrome. A blockage in this area can result in an infarction of the lateral medulla, which is a source of many impairments. Gaspard Vieusseux first described the condition in 1808, and Adolf Wallenberg described it in detail in 1895.
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A stroke in the brain stem is one of the leading causes of Wallenberg syndrome. This condition has a variety of symptoms, including difficulty swallowing, dizziness, hoarseness, nausea, and nystagmus, but there is no definitive diagnosis. Fortunately, the symptoms may improve within weeks. However, in severe cases, the disease can result in long-term neurological problems, which may require intensive treatment. You should seek medical attention immediately if you suspect you have the condition.
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An LMI is a unilateral lesion in WS that affects oropharyngeal swallowing. The lesion affects premotor neurons in the nucleus ambiguus, which disrupt their links to swallowing-related cranial motor neuron pools on the opposite side. These remaining premotor neurons may be responsible for the swallowing disorders in WS. As a result, dysphagia may be overcome by the contralateral center in the medulla oblongata.
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Swallowing disorders are common in WS patients. When stroke occurs, the central pattern generator responsible for deglutition cannot operate sequential muscle activity in the oropharynx. The result is severe incoordination of the swallowing muscles and an abnormally prolonged process. Patients with WS may experience difficulty swallowing even small amounts of liquid, and their symptoms will differ from those without the syndrome. In addition, swallowing difficulties are more pronounced in patients with hemispheric stroke. Patients with this disease also tend to experience difficulty controlling the bolus during swallowing.