• Clinical science

Wallenberg syndrome (Lateral medullary syndrome)

Abstract

Wallenberg syndrome is a neurological condition caused by a lateral medullary infarction, which results from occlusion of either the posterior inferior cerebellar artery (PICA) or branches of the vertebral artery. For this reason, it is also referred to as lateral medulla syndrome or PICA syndrome. Symptoms include ipsilateral Horner syndrome, palate weakness, hemiataxia, and contralateral sensory disturbances. Management is supportive, and may include swallowing and speech therapy, as well as a feeding tube in some cases.

Etiology

Clinical features

Clinical features Structure affected
Ipsilateral
  • Dysphagia
  • ↓ Gag reflex
  • Hoarseness, dysphonia
Nucleus ambiguus motoric nucleus
  • Ataxia, dysmetria, dysdiadochokinesia
Inferior cerebellar peduncle

Sympathetic fibers

  • Nystagmus, diplopia
  • Vertigo (with falling towards the same side of the lesion) → vomiting

Vestibular nuclei

  • Loss of pain and temperature in the face
Trigeminothalamic tract (sensory)
Contralateral
  • Loss of pain and temperature in the trunk and limbs
Lateral spinothalamic tract (sensory)

References:[1][2]

Treatment

  • See stroke
  • Additional supportive therapy: speech and swallowing therapy