Wallenberg Syndrome (also known as lateral medullary syndrome or posterior inferior cerebellar artery syndrome) is a rare type of stroke that occurs in the brain stem area of the brain causing specific symptoms due to the area of damage.

A stroke occurs when the blood supply to a part of the brain is interrupted or severely reduced because of a clot, depriving brain tissue of oxygen and causing cell death in that localized area. In Wallenberg Syndrome, one of the two arteries of the brain stem is blocked causing damage in the lateral medulla of the brain and/or the cerebellum. The most commonly affected artery is the vertebral artery, followed by the PICA, superior middle and inferior medullary arteries. This type of stroke constitutes only about 2% of all strokes and usually occurs in patients over 40 with vascular risk factors such as diabetes, hypertension, and high cholesterol.

The medulla area of the brain controls functions such as speech, swallowing, and taste. The cerebellum controls motor coordination and balance. Damage to these areas causes symptoms such as imbalance, difficulty swallowing, vertigo, muscle weakness, nausea, hiccups, voice hoarseness, and sensory disturbances (such as pain and temperature sensitivity loss). This syndrome is characterized by sensory loss affecting the trunk and extremities on the opposite side of the injury and sensory loss affecting the face and cranial nerves on the same side with the injury. This crossed finding is diagnostic for the syndrome. Some patients may experience loss of taste on only one side of the tongue. Or they may have loss of sensation or numbness on only one side of the body.

Treatment of Wallenberg Syndrome focuses mainly on symptoms and rehabilitation. Blood thinners such as heparin may be initiated to keep the blood clot from expanding, and the patient may need to be treated with long-term blood thinners such as aspirin or Coumadin (warfarin) to help prevent future clots. Speech and/or swallowing therapy provide some benefit for patients affected in those areas. Physical therapy may be included for those with muscle weakness, balance, and gait problems. Some patients experience pain and may be prescribed over-thecounter pain medications or prescription pain meds including narcotics. The prognosis for Wallenberg Syndrome patients depends on the size and location of the damage caused by the stroke. Ten percent of patients may die from complications such as aspiration pneumonia, breathing difficulties, and cardiac arrhythmias. Some patients have a total resolution of symptoms after just a few weeks while others will sustain long-term damage and long-term symptoms. Usually though, symptoms resolve completely within weeks to months.

• Healthline.com
• Mashpedia.com
• AARPhealthcare.com
• NIH.gov