An Atypical Presentation of Left Lateral Medullary Syndrome – A Case Report

Renjen, PushpendraN; Krishnan, Ramesh; Chaudhari, Dinesh; Ahmad, Kamal

doi:10.4103/0028-3886.333445

Cited by 12 publications

(4 citation statements)

References 9 publications

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“…It can also present as Tapia syndrome where there is unilateral paralysis of tongue and vocal cords, as a result of simultaneous extracranial paralysis of recurrent laryngeal branch of vagus nerve and hypoglossal nerve. [ 1 2 3 4 ]…”

Section: Discussionmentioning

confidence: 99%

“…Lateral medullary syndrome (LMS) was first described by Gaspard Vieussux in 1808 and the first clinical description of this syndrome was given by Wallenberg in 1895. [ 1 ] It occurs due to the involvement of lateral segment of medulla either caused by thrombotic or embolic occlusion of vertebral artery or posterior inferior cerebellar artery (PICA) or due to vertebral artery dissection due to neck injury/chiropractic manipulation.…”

Section: Introductionmentioning

confidence: 99%

“…Finally, involvement of ascending sympathetic fibres is associated with development of ipsilateral Horner’s syndrome. [ 1 2 ]…”

Section: Introductionmentioning

confidence: 99%

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Lateral medullary syndrome: Case report and review of literature

Singh

Thapliyal

Garg

2022

J Family Med Prim Care

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A BSTRACT Lateral medullary syndrome (LMS) or Wallenberg’s syndrome is an uncommon and often underdiagnosed cause of posterior circulation stroke. Thrombosis, embolization, or dissection of vertebral or posterior inferior cerebellar artery (PICA) often results into LMS. The most pathognomonic symptoms of LMS includes pain and temperature deficits on ipsilateral facial side and contralateral side of rest of the body, ipsilateral ataxia, vertigo, nystagmus, dysphagia, hoarseness, hiccups and Horner’s syndrome. We report a case of LMS in a 49-year-old Indian female with no known classical risk factors for stroke who presented with chief complaints of debilitating headache. Clinical examination was suggestive of LMS and radiological investigation confirmed the diagnosis. Patient’s hospital stay was uneventful and she was discharged to home with gradual improvement in her symptoms.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Lateral medullary syndrome: Case report and review of literature

Singh

Thapliyal

Garg

2022

J Family Med Prim Care

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“…In 1808, Gaspard Vieusseux became the first individual to define LMS. Additionally, in 1985 and 1901, through clinical and autopsy findings respectively, Wallenburg further highlighted LMS, thus adding value to the medical literature [ 1 ]. Occlusive conditions, including embolism or atherothrombosis, affect posterior inferior cerebellar and vertebral arteries, leading to LMS.…”

Section: Introductionmentioning

confidence: 99%

Acute dysphagia: A rare initial symptom of lateral medullary syndrome: A case report☆

Ali

Zubair²,

Nazir³

et al. 2022

Annals of Medicine &Amp; Surgery

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Wallenberg syndrome associated with hysteria: A case report

2024

Medicine: Case Reports and Study Protocols

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Rationale: Wallenberg syndrome, also referred to as posterior inferior cerebellar artery syndrome, represents the most prevalent form of bulbar syndrome and typically arises from occlusion of the posterior inferior cerebellar artery or its perforator artery. This vascular impairment can result in profound dysphagia, significantly compromising both survival time and quality of life for stroke survivors. Managing swallowing disorders associated with Wallenberg syndrome alone poses considerable challenges, while diagnosing and treating complex swallowing disorders stemming from other etiologies present formidable obstacles for clinicians and rehabilitation therapists alike. Naturally, such intricate swallowing disorders are infrequently encountered in clinical practice. Patient concerns: The dysphagia experienced by a 60-year-old Asian male with right medulla infarction was severe, rendering him unable to swallow any food or saliva. However, unlike typical bulbar palsy patients, these individuals exhibit functional dysphagia disorders in addition to neurodysphagia. Notably, there is no damage observed in the brain’s cognitive areas; however, evident cognitive impairment related to swallowing is present. Diagnosis: Swallowing disorders associated with Wallenberg syndrome, in conjunction with swallowing hysteria syndrome, were examined. Interventions: Cognitive training incorporating mirror swallowing techniques, high‐intensity electrical stimulation, and balloon expansion therapy. Outcomes: Following treatment, the patient swiftly regained normal swallowing function within a span of 21 days, and this functionality was sustained during the six-month follow-up period. Lessons: Wallenberg syndrome frequently presents with severe dysphagia, characterized by complex and debilitating symptoms, resulting in a poor prognosis. Due to the prolonged requirement of nasogastric feeding even after treatment, alternative etiologies for dysphagia are often overlooked. Isolated hysterical swallowing syndrome is relatively uncommon in clinical practice, particularly when coexisting with Wallenberg syndrome; however, fortunately, it exhibits a more favorable recovery outcome. The objective of this case report is to prompt clinicians and rehabilitation therapists to consider other potential causes of swallowing disorders in patients with Wallenberg syndrome when conventional treatments prove ineffective, thereby enhancing the rehabilitative outcomes for these individuals.

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An Atypical Presentation of Left Lateral Medullary Syndrome – A Case Report

Cited by 12 publications

References 9 publications

Lateral medullary syndrome: Case report and review of literature

Lateral medullary syndrome: Case report and review of literature

Acute dysphagia: A rare initial symptom of lateral medullary syndrome: A case report☆

Wallenberg syndrome associated with hysteria: A case report

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