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Wallenberg Syndrome - Oren Zarif - Wallenberg Syndrome


Patients with Wallenberg syndrome may experience hypotonia in the ipsilateral arm and uvula deviation. To demonstrate the hypotonia, patients can raise and lower both arms with their hands outstretched. The symptomatic arm will overshoot the braking motion compared to the unaffected arm. A feeding tube may be recommended if swallowing is difficult. The outlook for recovery of patients with Wallenberg syndrome varies from person to person.

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Initially, Wallenberg described Wallenberg syndrome as "Acute Bulbaraffection," in a paper published in 1895. He also described the disease as "Emboli der Arteria cerebelli posterior inferior sinistra" (p. 516). Symptoms include dizziness, difficulty swallowing, hoarseness of voice, and pain in the neck and left eye. However, the condition has now been attributed to a variety of vascular causes.

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Ischemic strokes can affect any part of the nervous system, but if the blood vessels to the brain stem become blocked, the disease will manifest itself as Wallenberg syndrome. Most often, the ischemic injury will affect the vertebral arteries, or the posterior inferior cerebellar artery (PICC). However, in rare cases, it can also occur in the medullary arteries. As the name suggests, it is important to seek medical care for ischemic stroke.

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The prognosis of people with Wallenberg syndrome varies greatly depending on the size of the infarct. While Wallenberg syndrome is less common than other types of acute ischemic stroke, it can still result in significant disability. Gait instability is the most common lingering problem. Early physical and occupational therapy is crucial for post-stroke recovery. While Wallenberg syndrome can result in gait instability and ataxia, it generally improves with time.

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Patients with Wallenberg syndrome often experience both saccadic and gaze-holding abnormalities. They may exhibit horizontal saccades away from the lesion and hypermetric saccades toward the lesion. Skew deviation is a motor compensatory response to the lesion-induced subjective head-eye tilt. Further, the lesion may damage the lateral medullary regions. When combined with ocular torsion or lateral medullary lesions, these two abnormalities result in asymmetrical ocular alignment.

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There are a few diagnostic methods for Wallenberg syndrome. Although this syndrome is rare, it can be detected with MRI and electrophysiology. It is often caused by either a lateral medullary infarction or a PICA embolism. Neuromuscular electrical stimulation (NMES) and speech therapy are useful in many cases. An specialized NMES device called VitalStim has been cleared for treatment of pharyngeal dysphagia in patients with Wallenberg syndrome. These methods are administered by occupational therapists and speech and language pathologists.

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The most widely recognized treatment for Wallenberg syndrome involves a diet rich in zinc. Vitamins B12 and C are also helpful. A balanced diet is also beneficial, as they reduce the risk of cardiovascular disease. The syndrome is also a great way to boost the immune system. Vitamins A and E are also essential for preventing or combatting the symptoms of wallenberg syndrome. The National Institutes of Health runs the Genetic and Rare Diseases Information Center (GNIC).

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Affected regions of the brain are also involved in swallowing. The LMI has an effect on the premotor neurons of the nucleus ambiguus, which appears to disrupt their links to swallowing-related cranial motor neuron pools. If intact, the remaining premotor neurons may cause or contribute to the dysphagia in WS. Dysphagia may also be a result of a disorder in the contralateral medulla oblongata.

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Patients with WS often have difficulty swallowing food or liquids. Electrophysiological studies have shown a greater frequency of oral and pharyngeal swallowing disorders in patients with WS than in those without the disorder. In hemispheric stroke patients, laryngeal elevation is delayed compared to other stroke patients. Patients with WS have difficulty controlling bolus and have difficulty with swallowing food. This suggests that the underlying problem is not affecting the upper respiratory system.

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