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Wallenberg Syndrome - Oren Zarif - Wallenberg Syndrome


A patient who presented with dizziness and a burning sensation on the left side of their face was diagnosed with Wallenberg syndrome. She also experienced difficulty in breathing, decreased left arm and leg strength, and had a decrease in the sensation of temperature on the left side. She exhibited a tendency to lean to the left side and was unable to stand upright. A brain MRI revealed a lateral hyperintense lesion in the left posterior medulla, confirming the diagnosis of Wallenberg syndrome.

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Treatment for Wallenberg syndrome is similar to that for acute stroke. The goal of treatment is to reduce the size of the infarction and prevent medical complications. Long-term treatment involves speech and swallowing therapy and early physical and occupational therapies. The prognosis of a patient with Wallenberg syndrome depends on the severity of the stroke and where the damage occurred in the brain stem. Patients with this syndrome may experience significant neurological disabilities for years. The outlook for a full recovery varies from person to person.

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Wallenberg syndrome is a collection of symptoms caused by posterior vascular accidents. While an MRI with DWI is the gold standard for diagnosing the disorder, many cases of this condition can be misdiagnosed due to normal MRIs. Early management of the symptoms can be life-saving. A patient with Wallenberg syndrome should seek medical attention immediately. And if it is not treated correctly, it can lead to permanent neurological problems.

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During the first week following an ischemic stroke, treatment should include speech therapy.

Symptoms of Wallenberg syndrome include impaired swallowing and sensory disturbance on the soft palate. Patients may also experience smaller pupils or drooping eyelids. They may also experience tinnitus or a decrease in pain sensation. Recovery depends on the type of damage and the severity of the condition, and recovery can last from six weeks to six months. Some patients experience permanent disabilities. They should seek medical attention immediately after a stroke.

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Lateral medullary syndrome may also present with nystagmus, which may be a result of direct vestibular damage. In rare cases, the lesion may be causing vestibular damage, or it could be otolithic connections. Either way, the condition may present with horizontal, torsional, or vertical nystagmus. Symptoms of lateral medullary syndrome include diplopia, hiccups, and unilateral posterior headache. Patients with the disease may also experience a head impulse test.

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Acute stroke in the lateral medulla can lead to severe neurological impairments, including mental retardation, apathy, and even death. A postmortem performed by Wallenberg in 1894 confirmed the lesion to be in the posterior inferior cerebellar artery. The symptoms usually appear only in elderly patients. The most common risk factors include smoking and hypertension. However, there are some preventive measures that can be taken to reduce the risk of this condition.

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The treatment of WS is time-dependent and largely determined by the type of underlying cause. Surgical procedures involving intravenous TPA may be effective in many cases, and neuromuscular electrical stimulation (NMES) has been used to improve dysphagia. Optical therapy may be beneficial in cases where diplopia is unresolved. Symptomatic relief with this treatment may be possible within a month or two.

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In WS, sequential muscle activity in the oropharynx is compromised. The resulting incoordination and lengthening of the swallowing process may be severe. However, the severity and duration of dysphagia depend on the extent of the lesion in the patient. The majority of patients have a limited water intake. The condition may be exacerbated by a previous stroke. In addition, WS can lead to a hemispheric stroke, as the central pattern generator is not functioning correctly.

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In some cases, LMI is the cause of dysphagia. In these cases, the patient's brainstem may show a gray-yellow discoloration. The lesion does not cross the midline. The left VA has a pronounced narrowing of its lumen. The right VA shows hypoplastic changes while the left is unaffected. Despite the differences between left and right sides, the left AICA remains patent.

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