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Wallenberg Syndrome

Written by Tricia Kinman
Medically Reviewed by George Krucik, MD, MBA on June 18, 2013

What Is Wallenberg Syndrome?

Wallenberg syndrome is a rare condition in which an infarction, or stroke, occurs in the lateral medulla. The lateral medulla is a part of the brain stem. When the arteries that lead to this part of the brain are blocked, oxygenated blood doesn’t get to this part of the brain, and a stroke can occur. This condition is also sometimes called lateral medullary infarction. However, the cause of the syndrome isn’t always clear.

Symptoms of Wallenberg Syndrome

Because the brain stem is in charge of delivering messages to the spinal cord for motor and sensory function, a stroke in this area causes problems with how the person’s muscles function and sensations are perceived. The most common symptom people with Wallenberg syndrome have is dysphagia, or difficulty swallowing. This can become very serious if it affects how much nutrition you are getting. Other symptoms include:

  • hoarseness
  • nausea and vomiting
  • hiccups
  • rapid eye movements  (nystagmus)
  • a decrease in sweating
  • problems with body temperature sensation
  • dizziness
  • trouble walking
  • trouble with maintain your balance

In some cases, people with Wallenberg syndrome experience paralysis or numbness on one side of the body. This can occur in the limbs, in the face, or even in a small area like the tongue. You can also experience a difference in how hot or cold something is on one side of the body. Some individuals will walk at a slant or report that everything around them seems tilted or off balance.

The syndrome can also cause changes in your heart rate (bradycardia) and blood pressure (hypo- and hypertension).  Make sure to discuss any symptoms you have with your healthcare provider. Every bit of information can help in making the diagnosis.

Who Is at Risk?

Researchers have yet to figure out why this type of stroke occurs. However, some researchers have found a connection between those who have artery disease, heart disease, blood clots, or minor neck trauma from rotational activities and Wallenberg syndrome. Minor neck trauma is a common cause among patients who are under 45 years old. If you have any history of these problems, be sure to tell your healthcare provider.

How Is Wallenberg Syndrome Diagnosed?

Usually a doctor will make a diagnosis after carefully reviewing your health history and listening to the description of your symptoms. If your healthcare provider suspects that you have Wallenberg syndrome, you may undergo a computed tomography (CT) scan or magnetic resonance imaging (MRI) to confirm whether or not there is a block in the artery near the lateral medulla.

How Is Wallenberg Syndrome Treated?

There is no cure for this condition, but your healthcare provider will probably focus treatment on relieving or eliminating your symptoms. He or she may prescribe speech and swallowing therapy to help you learn to swallow again. If your situation is severe, your doctor may recommend a feeding tube so you can get the nutrients you need.

In some cases, you may be prescribed medication. You may be given pain medication if you have chronic or long-lasting pain. A blood thinner, such as heparin or warfarin, may be prescribed to help reduce or dissolve the blockage in the artery. This can also help to prevent future blood clots from forming.  Sometimes an anti-epileptic or anti-seizure drug called gabapentin can help with the symptoms. In extreme cases, surgery may be an option to remove the clot. This is not as common of a treatment, however, because of the difficulty of getting to that area of the brain.

Make sure to discuss your treatment options with your healthcare provider and follow the plan carefully.

What Is the Long-Term Outlook for Wallenberg Syndrome?

Although the diagnosis and symptoms can be frightening, the long-term outlook for Wallenberg syndrome is actually fairly positive. How well you recover depends on where the stroke happened in the brainstem, as well as how much damage occurred. Some people can recover between a few weeks to six months after treatment. Others with more significant damage may have trouble or more permanent disabilities. You should discuss your long-term outlook with your healthcare provider if you have any questions. Be sure to follow your treatment plan carefully so you can make a successful recovery.

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