Presentation
[…] comparatively rare, with hypoglossal neuropathies reported in only several cases of MADSAM. 2, 3, 4 A case report demonstrated hypoglossal neuropathy in a patient masquerading as motor neuron disease. 4 Inconsistent with that case, the symptoms in the present [synapse.koreamed.org]
INTRODUCTION Strokes in the distribution of the posterior circulation may present vertigo, imbalance and nystagmus [ 1 ]. A stroke involving the brain stem and cerebellum frequently presents acute vestibular syndrome [ 2 ]. [academic.oup.com]
[…] half of the face Loss of sensation of pain and temperature of contralateral half of the trunk Hoarseness, Diplopia Dysphagia Hiccups Dysphonia Horner’s syndrome Poor gag reflex Ataxia of both limb and gait Bradycardia Diagnosis After the assessment of present [lecturio.com]
It is our ambition to present a complete survey of all medical phenomena named for a person, with a biography of that person. Disclaimer: Whonamedit? does not give medical advice. [whonamedit.com]
Clinical features of central pain were reviewed in a series of lectures and case presentations by George Riddoch in 1938 and are still worth reading for the classical description ( Riddoch 1938 ). [medlink.com]
Entire Body System
-
Physician
Ramskill, Radcliffe, Hughlings-Jackson and Buzzard; physicians for outpatients, Drs. H. Charlton Bastian, AY. R. Gowers, and D. Ferrier Assistant Physicians, Drs. J. A. Ormerod and P. [worldneurologyonline.com]
In the 1950s clinical experience of several physicians further elaborated the findings in neuropathic pain ( Noordenbos 1959 ). [medlink.com]
A dictionary of medical eponyms Born 1863 Died 1940 Related eponyms Spiller's syndrome Spiller-Frazier operation American physician, born September 13, 1863, Baltimore; died 1940. [whonamedit.com]
Chief Editor Additional Contributors Acknowledgements The authors and editors of Medscape Reference wish to thank Suneet Sahgal, MD, Staff Physician, Department of Physical Medicine and Rehabilitation, Northwestern University Medical School, for his previous [emedicine.medscape.com]
J Assoc Physicians India. 1999; 47 1110-1111 27 Kleinschmidt-De Masters B K, Avakian J J. Wallenberg syndrome caused by CSF metastasis from malignant intraventricular meningeoma. [thieme-connect.com]
-
Weakness
It is identified by ipsilateral tongue weakness, ipsilateral tongue deviation and contralateral motor weakness. Lateral medullary syndrome is commonly due to PICA or vertebral artery occlusion. [lecturio.com]
However, both the muscle weakness and wasting gradually progressed. [synapse.koreamed.org]
Onset is also generally at an early age, and a more diffuse distribution of weakness occurs. [emedicine.medscape.com]
-
Unconsciousness
[…] lateral medullary segment Inferior cerebellar peduncle: mainly concerned with proprioception, integration and co-ordination of motor tasks, following tracts traverse the inferior cerebellar peduncle: Tract Function Dorsal spinocerebellar tract Conveys unconscious [lecturio.com]
-
Falling
[…] beschriebenen Falle. Arch Psych Nervenheilkd. 1901; 34 923-959 12 Mumenthaler M, Mattle H. Neurologie. 11. Auflage. Stuttgart: Thieme 2002 13 Tettenborn B. Klinische Symptome und hinterer Kreislauf. [thieme-connect.com]
Respiratoric
-
Hoarseness
Trigemino-thalamic tract from spinal nucleus of trigeminal nerve Loss of pain and temperature sensation from ipsilateral half of the face Nucleus ambiguus and solitary nucleus Lower cranial nerve dysfunction-hoarse voice, nasal twang and dysphonia, dysphagia [lecturio.com]
A 68-year-old woman suddenly developed vertigo, ipsilateral facial paresis, contralateral thermal hypoalgesia (TH) and dysphagia without lateral gaze palsy, curtain sign and hoarseness. [academic.oup.com]
-
Aspiration
Patients with lower cranial nerve weakness in lateral medullary syndrome are prone to aspiration pneumonia. They might benefit from Ryle’s tube feeds or diverted feeding techniques like gastrostomy. [lecturio.com]
CPD may have led to severe dysphagia and aspiration [ 16 ]. Symptoms of CPD can range from a globus sensation to oropharyngeal dysphagia manifested by regurgitation, coughing choking and recurrent aspiration [ 17 ]. [academic.oup.com]
-
Pneumonia
Patients with lower cranial nerve weakness in lateral medullary syndrome are prone to aspiration pneumonia. They might benefit from Ryle’s tube feeds or diverted feeding techniques like gastrostomy. [lecturio.com]
Gastrointestinal
-
Dysphagia
Transcranial magnetic stimulation is given in repetition to rehabilitate patients having dysphagia due to Wallenberg syndrome. Patients with lower cranial nerve weakness in lateral medullary syndrome are prone to aspiration pneumonia. [lecturio.com]
Finally, her dysphagia regressed over 4 weeks in synchronization with recovery of TH. [academic.oup.com]
Dysphagia in unilateral medullary infarction: lateral vs medial lesions. Neurology 2005 ; 65 : 714 –718. 17. Calne DB, Pallis CA. Vibratory sense: a critical review. Brain 1966 ; 89 : 723 –746. 18. Kim JS. [cambridge.org]
Scleroderma, polymyositis, and dermatomyositis: Differentiation from scleroderma, polymyositis, and dermatomyositis may be made by their clinical courses, which are often characterized by more rapid progression, involvement of skin and neck muscles, and dysphagia [emedicine.medscape.com]
-
Gagging
[…] spinal nucleus of trigeminal nerve Loss of pain and temperature sensation from ipsilateral half of the face Nucleus ambiguus and solitary nucleus Lower cranial nerve dysfunction-hoarse voice, nasal twang and dysphonia, dysphagia, decreased gustation weak gag [lecturio.com]
Gag reflex was preserved. The tone of her voice was the same as it was before these symptoms developed. Magnetic resonance (MR) imaging showed a small infarction at the MPMJ (Fig. 1 E and F). [academic.oup.com]
-
Regurgitation
[…] nucleus of trigeminal nerve Loss of pain and temperature sensation from ipsilateral half of the face Nucleus ambiguus and solitary nucleus Lower cranial nerve dysfunction-hoarse voice, nasal twang and dysphonia, dysphagia, decreased gustation weak gag, regurgitation [lecturio.com]
Symptoms of CPD can range from a globus sensation to oropharyngeal dysphagia manifested by regurgitation, coughing choking and recurrent aspiration [ 17 ]. [academic.oup.com]
-
Hiccup
Symptoms and Diagnosis of Medullary Syndrome Frequently being acute ischemic events, brain stem strokes are characterized by vomiting, vertigo, diplopia, headache, ataxia, hiccups and dysarthria. [lecturio.com]
-
Vomiting
Symptoms and Diagnosis of Medullary Syndrome Frequently being acute ischemic events, brain stem strokes are characterized by vomiting, vertigo, diplopia, headache, ataxia, hiccups and dysarthria. [lecturio.com]
Eyes
-
Diplopia
Symptoms and Diagnosis of Medullary Syndrome Frequently being acute ischemic events, brain stem strokes are characterized by vomiting, vertigo, diplopia, headache, ataxia, hiccups and dysarthria. [lecturio.com]
She complained of no diplopia. Curtain sign of the soft palate, as well as vocal cord paresis, was absent. Gag reflex was preserved. The tone of her voice was the same as it was before these symptoms developed. [academic.oup.com]
-
Blurred Vision
vision Disbalanced sitting posture Horizontal or roatational nystagmus Loss of sensation of pain and temperature of half of the face Loss of sensation of pain and temperature of contralateral half of the trunk Hoarseness, Diplopia Dysphagia Hiccups Dysphonia [lecturio.com]
Psychiatrical
-
Impulsivity
HINTS (head- impulsive-nystagmus- test of skew) is a three –step oculomotor examination that can determine the presence of infarction in lateral medulla. Imaging studies are often the preliminary investigations performed. [lecturio.com]
The neural impulse or inappropriate conductivity to or from the central nervous system may indirectly affect healthy peripheral striated muscular system [ 15 ]. This may be the same for the muscles involved in hyolaryngeal elevation [ 15 ]. [academic.oup.com]
Neurologic
-
Cerebellar Sign
Tract involved in lateral medullary syndrome Manifestation Inferior cerebellar peduncle Ipsilateral ataxia, ipsilateral appendiceal cerebellar signs as dysmetria, intentional tremors Vestibular nuclei Vomiting, vertigo, nystagmus, diplopia. [lecturio.com]
signs) [ 5 ], Dajuren (hypoglossal nerve palsy and contralateral hemiparesis) [ 6 ], Reinhold (ipsilateral hypoglossal nerve palsy, contralateral hemiparesis sparing the face and Wallenberg’s syndrome) [ 7, 8 ], Babinski-Nageotte syndrome (contralateral [academic.oup.com]
-
Paresis
A physical examination revealed right peripheral type facial paresis and left-beating nystagmus, despite no paresis nor ataxia of extremities. Horner’s syndrome was not detected. [academic.oup.com]
Facial paresis, though rare, can be seen due to involvement of few aberrant descending fibers. It can causes ailments of many systems like vestibule-cerebellar, bulbar, sensory, respiratory or autonomic systems. [lecturio.com]
-
Hyperalgesia
Horner’s syndrome, ipsilateral ataxia and ipsilateral hyperalgesia of the face Ipsilateral ataxia, contralateral Horner’s syndrome and ipsilateral hyperalgesia of the body. [lecturio.com]
In the 1930s Lewis and Hardy conducted experimental work to explain the underlying mechanisms of hyperalgesia and hyperesthesia ( Lewis 1936 ; Hardy et al 1950 ). [medlink.com]
-
Vertigo
Symptoms and Diagnosis of Medullary Syndrome Frequently being acute ischemic events, brain stem strokes are characterized by vomiting, vertigo, diplopia, headache, ataxia, hiccups and dysarthria. [lecturio.com]
Vascular vertigo is known to usually accompany other neurologic symptoms and signs [ 2 ]. Appropriate bedside evaluation is superior to MRIs for detecting central vascular vertigo syndromes [ 1 ]. [academic.oup.com]
-
Tremor
Tract involved in lateral medullary syndrome Manifestation Inferior cerebellar peduncle Ipsilateral ataxia, ipsilateral appendiceal cerebellar signs as dysmetria, intentional tremors Vestibular nuclei Vomiting, vertigo, nystagmus, diplopia. [lecturio.com]
Treatment
Although there have been advances in understanding the pathophysiology of pain and several new methods of treatment, management of neuropathic pain remains a difficult problem. Classification. [medlink.com]
The long-term outlook depends on active rehabilitation and symptomatic treatment. Transcranial magnetic stimulation is given in repetition to rehabilitate patients having dysphagia due to Wallenberg syndrome. [lecturio.com]
In Berlin the use of electricity in diagnosis and treatment was given by Martin Bernhardt (of the Bernhardt-Roth syndrome, a.k.a. meralgia paresthetica) and Ernst Julius Remak (son of Robert Remak). [worldneurologyonline.com]
On the classification, natural history and treatment of the myopathies. Brain. 1954. 77(2):169-231. [Medline]. Fanin M, Tasca E, Nascimbeni AC, et al. [emedicine.medscape.com]
Surgical treatment of an intramedullary haematoma simulating Wallenberg's syndrome. J Neurol Neurosurg Psychiatry 1964 ; 27 : 78 –80. 44. Neumann PE, Mehler MF, Horoupian DS. Primary medullary hypertensive hemorrhage. [cambridge.org]
Prognosis
Patients who require tracheostomy usually have guarded prognosis. [lecturio.com]
The clinical syndromes, vascular risk factor profile, presumed etiology of stroke, and prognosis allow consideration of small and large AChA territory infarcts in the differential diagnosis of patients with brain ischemia. [cambridge.org]
Etiology
Etiology These syndromes are classically caused by ischemic strokes that occur secondary to occlusion of small perforating arteries of the posterior circulation, however many have also been described secondary to hemorrhage, neoplasm, and demyelination [radiopaedia.org]
The etiology can be detected by performing studies like CT angiography, MRI angiography and Arterial neck Doppler. For large vessel disease, digital subtraction angiography is the gold standard. [lecturio.com]
The high prevalence of arterial hypertension or diabetes mellitus as an isolated risk factor of stroke in small-sized AChA infarcts suggests that small artery disease is a common etiology of AChA territory infarcts. [cambridge.org]
The anatomic basis and etiology of the alternating medullar syndromes, and the main publications relating to these syndromes were discussed. [thieme-connect.com]
Epidemiology
Epidemiology There are very few clinically and pathologically proven patients of medial medullary syndrome. Lateral medullary syndrome is relatively more common. [lecturio.com]
Pathophysiology
This clinical article discusses the pathophysiology of central neuropathic pain and its classification and differentiation from peripheral neuropathic pain. [medlink.com]