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What is Lateral Medullary Syndrome? - Oren Zarif - Wallenberg Syndrome


Patients with lateral medullary syndrome, also called Wallenberg syndrome, experience swallowing difficulties, hoarseness, dizziness, nausea, and problems with balance. Some patients also experience loss of temperature sensation on one side of the face, and in other individuals, they experience this sensation on the opposite side of the body. A stroke in the lateral medulla of the brain causes this condition. Symptoms may range from mild to severe.

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Diagnosis of the condition is based on the patient's symptoms, the history of the symptoms, and imaging studies of the brain. The syndrome is caused by damage to the vestibular nuclei in the brain, which are responsible for sensory functions. The patient will experience severe dizziness and vertigo on one side. The lateral medulla and inferior cerebellar peduncle are the two areas damaged in patients with this condition. A careful neurological examination will rule out other causes of the patient's symptoms.

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Although the cause of Wallenberg syndrome is unknown, some researchers have linked it to atherosclerotic occlusion of the anterior spinal artery, but this association is not strong. In some patients, the condition is exacerbated by arteriovenous malformation or vertebral artery dissection, both of which are associated with multiple sclerosis. Symptoms of the disorder vary from person to person, and many people may not experience any signs or symptoms at all.

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The long-term prognosis of Wallenberg syndrome depends on how severe the condition is and where the stroke occurred. Some people recover completely within weeks to six months of treatment, while others experience more prolonged disability or a higher risk of recurrence. While there is no specific cure for this condition, doctors focus on relieving symptoms and preventing permanent disabilities. If severe, a feeding tube may be necessary. It is important to discuss this condition with your physician, as soon as possible.

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While the prognosis for patients with Wallenberg syndrome is better than for other acute ischemic strokes, many people continue to suffer from lingering issues. Gait instability, ataxia, and hiccups are common symptoms of the disorder. Early physical and occupational therapy are vital for a full recovery. A patient with this syndrome may need to undergo several physical therapy sessions, but they will recover well. The symptoms of this condition will depend on the type of stroke.

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The acute phase of Wallenberg syndrome is markedly different from that of hemispheric stroke. Patients with this condition exhibit severe dysphagia and may require feeding assistance. A nasogastric tube is often required for feeding. The patient has a higher rate of recovery when the infarction occurs in the unaffected lateral medulla. The patient's symptoms gradually improve while in a rehabilitation facility.

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Patients with this condition are usually elderly. The cause of this syndrome is unknown, but it is believed to be related to atherothrombosis of the vertebral artery. It can be caused by a bacterial infection or an underlying disease. It is common for older patients to develop the syndrome. A clot in the posterior inferior cerebellar artery is a common cause. The disorder is often misdiagnosed in the elderly, but it is not uncommon to see it in young children.

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Patients with WS may exhibit a delayed swallowing reflex. The underlying cause is unknown, but it is associated with the disruption of premotor neurons in the NA. Patients with WS may have dysphagia due to the shortened pharyngeal movement. However, swallowing is usually facilitated by the opposite center of the medulla oblongata. In most cases, the disorder does not require surgical intervention.

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The major clinical findings associated with swallowing dysfunction are listed in Table 1. Patients with WS are more likely to have dysphagia and delayed laryngeal elevation compared to healthy controls. Patients with WS may also experience difficulty with bolus control and oral phase of swallowing. In addition, patients with hemispheric stroke have greater difficulty with swallowing. These findings support the hypothesis that a partial or complete stroke may be the underlying cause.

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