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  • Writer's pictureOren Zarif

Symptoms and Diagnosis of Wallenberg Syndrome - Oren Zarif - Wallenberg Syndrome

There are several symptoms associated with Wallenberg syndrome, and the diagnosis of the disorder is based on the patient's history, physical examination, and radiographic imaging. These symptoms are caused by damage to the vestibular nuclei and the lateral medulla, a structure of the brain that is responsible for balance. The patient often experiences dizziness and vertigo, as well as hoarseness of voice and difficulty swallowing. The condition can develop over several hours or days, depending on the severity of the symptoms.

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The prognosis for Wallenberg syndrome depends on the location and size of the affected brain stem. Acute stroke patients may improve within weeks or months. Long-term patients may experience significant neurological disabilities. Treatment is critical for the patient's recovery. Treatment options include rehabilitation, speech and swallowing therapy, and physical and occupational therapy. Despite the lack of standardized outcomes for Wallenberg syndrome, there are a number of options to help patients recover.

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There is no definitive diagnosis for the condition, although some researchers suspect that a vertebral artery dissection is the most likely cause. In 1894, a German physician named Wallenberg described the symptoms of the syndrome, which he categorized as an embolism of the posterior inferior cerebellar artery. Today, there is no known cause of the disorder, but there are some risk factors that can increase the risk. However, the most common risk factor for this disorder is smoking.

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Atypical neurological features of Wallenberg's syndrome include ocular motor abnormalities. Affected patients exhibit signs of ocular alignment dysfunction, including excyclodeviation, disconjugate ocular torsion, and impaired contralateral pursuit. Patients may also complain of diplopia or an unusual environment tilt. The diagnosis should be made by a board-certified ophthalmologist and is based on objective findings.

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Patients with Wallenberg syndrome may also experience speech problems, hoarseness, dizziness, nystagmus, and difficulty swallowing. MRI scans of the patient's brain showed that the infarction had spread to the lower portions of the medulla and cervical spinal cord. The patient also showed the greatest motor weakness in his left lower extremity. Although Wallenberg syndrome is typically temporary, it can lead to a long-term neurological condition.

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The diagnosis of Wallenberg's syndrome is complicated by the lack of a definite cure. Its cause is unclear, but the most common cause is a stroke of one of two brainstem arteries. Research on this disorder is ongoing at NIH and major medical institutions. The goal of the research is to develop treatments for the disorder and cure it entirely. This is the best way to determine whether a patient has the disorder.

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Studies on WS patients have revealed an increased jitter on the peaks of the second laryngeal deflections. Patients with WS had significantly longer jitter than patients with normal laryngeal muscles. The jitter correlated with an increased variability in the 0-2 interval. These findings suggest that LMI is a contributing cause of dysphagia in Wallenberg syndrome. The patient's symptoms may not even be attributed to the stroke itself.

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LMI can lead to a lesion on one side of the nucleus ambiguus in WS, affecting the oropharyngeal swallowing. It appears to affect premotor neurons in the nucleus ambiguus, and may disrupt their linkage with swallowing-related cranial motor neuron pools in the opposite hemisphere. The remaining intact premotor neurons may be responsible for dysphagia in WS.

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Electrophysiological studies have indicated that a single hemispheric stroke may affect the central pattern generator of swallowing. While the other half remains intact, this stroke may cause severe dysphagia and impair the ability to speak or swallow. The duration and severity of the dysphagia in WS patients depend on the extent of the lesion. The patient with WS may also exhibit atypical swallowing behaviors. It is important to consult a doctor if symptoms persist for long.

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