Lateral Medullary Syndrome (Wallenberg Syndrome)

https://radiopaedia.org/articles/lateral-medullary-syndrome?lang=us

1/5 strokes in posterior circulation

lateral medullary syndrome is the most common of the posterior circulation strokes

Structures affected

• inferior cerebellar peduncle
• dorsolateral medulla
• descending spinal tract
• nucleus of the V nerve
• vagus nerve and nucleus
• glossopharyngeal nerve and nucleus
• descending sympathetic fibers

Signs and Symptoms

• vestibulocerebellar symptoms
  • ipsilateral hemiataxia
  • vertigo
  • falling toward side of lesion
  • multidirectional nystagmus (inferior cerebellar peduncle and vestibular nucleus)
• autonomics
  • ipsilateral Horner syndrome
  • hiccups
• sensory
  • loss of p&t over ipsilateral face & contralateral body
• bulbar
  • hoarseness
  • dysphonia
  • dysphagia
  • dysarthria
  • decreased gag reflex (nucleus ambiguus)

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