Efficacy of botulinum toxin type-A and swallowing treatment for oropharyngeal dysphagia recovery in a patient with lateral medullary syndrome

Abstract

contralateral face and body; type 4: ipsilateral face and contralateral trunk and leg; type 5: contralateral face, arm and upper trunk.the swallowing pattern generator is located in the dorsolateral medulla oblongata and it consists primarily of the nucleus tractus solitaries, nucleus ambiguous and the reticular formation. 3 for this reason, occurrences of dysphagia symptoms are frequent from 51% to 94% and severity is documented to range from mild to severe in lMs patients. 4 here, we report a case of Ws-type 1-associated with l ateral medullary syndrome (lMs) is also known as posterior inferior cerebellar artery syndrome or Wallenberg's syndrome (Ws). it results from an occlusion of posterior inferior cerebellar artery or the vertebral artery. 1 the symptoms of lMs are recognised to be several and vary from patients to patients. 1, 2 Zhang et al. 2008 classified LMS in five type on the basis of sensory involvement pattern, anatomical localization and radiological pattern of involvement. 2 type 1: ipsilateral face and contralateral trunk and limbs; type 2: ipsilateral face and contralateral face, trunk and limbs; type 3: C

Late Diagnosis of a Patient With Gradual Onset of Lateral Medullary Syndrome Secondary to Spontaneous Vertebral Artery Dissection: A Case Report

“…Ipsilateral Horner syndrome, limb ataxia, loss of pain and temperature sensation over half of the face, and contralateral hypoalgesia of the body are all sensitive findings of LMS. Other unspecific but frequent symptoms are vertigo, dizziness, nausea, vomiting, and headache [ 1 , 11 , 12 ]. Diversity of presentations occurs when areas in danger are supplied by collateral flow or through residual perfusion.…”

Hitting a Wall: An Ambiguous Case of Wallenberg Syndrome

“…Diagnosis of Wallenberg syndrome is made clinically and diagnostically based on presenting symptoms, history of presentation, and radiographic imaging. The neurological deficits associated with this disease are due to damage of the lateral medulla, inferior cerebellar peduncle, nucleus of trigeminal nerve, nucleus and fibers of the vagus and glossopharyngeal nerves, descending sympathetic tract, spinothalamic tract, and/or vestibular nuclei [ 5 , 6 ]. The onset of the disease is acute.…”

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

“…Moreover, dysphagia, dysphonia, and dysarthria are caused by nucleus ambiguus pathology [ 4 ]. Other detrimental symptoms include ipsilateral facial pain, hypoalgesia, and thermoanesthesia from trigeminal nerve involvement (crossed brainstem syndrome), and hemisensory loss on the contralateral trunk and extremities from spinothalamic tract injury, with hypothalamo-spinal fibers lesions disrupting the sympathetic nervous system giving rise to Horner's syndrome [ [4] , [5] , [6] ]. Dysphagia is clinically significant because it is associated with aspiration pneumonia, malnutrition, increased mortality, and long hospital stay [ 6 , 7 ].…”