Lateral Medullary Syndrome: Wallenberg

Yıl 2025, Cilt: 16 Sayı: 4, 144 - 146, 31.12.2025

Nalan Cavlak Adsız

https://izlik.org/JA26DK72ZY

Öz

Abstract
Introduction: Lateral Medullary Syndrome (Wallenberg) is a severe neurological condition associated with intracranial pathology, particularly the occlusion of the posterior inferior cerebellar artery branch. Symptoms include Horner's syndrome, ipsilateral gait ataxia, and hypoalgesia, and ipsilateral thermoanesthesia of the face.
Case: A 52-year-old male patient presented with complaints of nausea, vomiting, and unsteady gait. The patient had undergone cardiac angioplasty 4 months ago but had not adhered to his prescribed medical treatment nor attended follow-up cardiology appointments. His symptoms, which began around noon, were further complicated by difficulty swallowing, hoarseness, and hiccups. As approximately 8 hours had passed since the onset of symptoms, thrombolytic therapy could not be administered. He was admitted to the neurology ward for further evaluation.
Conclusion: Lateral Medullary Syndrome (Wallenberg) can present with diffuse and subtle symptoms. Early hospitalization is crucial, especially for patients with a history of cardiac angioplasty, as timely intervention can be vital for improving outcomes.

References :
1. Neurologic Localization and Diagnosis, Chapter 3.4, 89-106.
2. Netter Collection of Medical İllustration: Nervous system, Part 1 Brain, Section 9,203-254.
3. Dizziness and Vertigo Across the Lifespan. Vertebrobasilar İnfarcts and İschemia. Chapter 16, 191-208.
4. Bradley and Daroff ‘s Neurology in Clinical Practise, 65, 964-1013.e7.
5. Lateral Medullary Syndrome. Alexander Rae-Grant MD, FRCPC,FAAN. Released September 28,2024.
6. A Case Report: Laterally Medullary Syndromewith Facial Nerve Palsy and Hemiparesis. Ramash Shrestha, Ghanshyam Kharel,Sharaddha Acharya, Rohit Pandit and Nitu Limbu. Annals of Medicine and Surgery, 2022-10-01, Volume 82, Article 104722,2022.
7. Basilar Artery Thrombosis and Wallenberg Syndrome in a Patient with Uncontrolled Hypertansion. Nazim Kadaj, Kaltrina Gocaj, Sebeze Kabashi, Kreshnike Dedushi, Vullnet Blakaj and Alba Goçaj. Radiology Case Reports, 2024-08-01, Volume 19, Issue 8, Pages 3033-3037.
8. Papa L, Meurer W. J. Rosen’s Emergency Medicine: Concepts and Clinical Practice,87,1224-1242.e4.2023
9. Aplin P., Mophett. Textbook of Adult Emergency Medicine,8.2,356-364.e1.2020
10. Tomsick T.A., Khatri P., Jovin T., et. al.: Equipoise among recanalization strategies. Neurology 2010; 74: pp. 1069-1076.
11. Biller J, Schneck M J, Ruland S. Bradley and Daroff’s Neurology in Clinical Practice,65,964-1013.e7.2022
12. Pelin Z., Bozluolcay M., Erkol G., Denktaş H., Latreal Medullar Sendromun bir Bulgusu Olarak Hıçkırık ve Tedavisi: Dört Olgu Sunumu. Cerrahpaşa Tıp Dergisi; 32: 115-119. (Pelin Z., Bozluolcay M., Erkol G., Denktaş H., Hiccup and its Treatment as a Manifestation of Lateral Medullary Syndrome: A Presentation of Four Cases. Cerrahpaşa Medical Journal; 32: 115-119.)
13. Park MH., Koh SB.,Park MK., Park KW., Lee DH. Lesional Location of Lateral Medullary İnfaction Presenting Hiccups(singultus). J. Neurol Neurosung Psychiatry.2005;76:95-98.
14. Ubaid Khan, Bilal Ahmad, Ayesha Aslam, Aiman Muhammad, Javed Iqbal. Opalski Syndrome, A Rare Variant of Wallenberg Sydrome, The First Case Report. Heliyon Volume 9, Issue 11, November2023,e21687.
15. Opalski A. A New Sub-bulbar Syndrome: Partial Sydrome of the Posterior Vertebrospinal Artery. Paris Medical 1946;214-20.
16. Maziar Emamikhah WD., Farzad Sina MD., Mahisa Mokhtari MD., Fatemeh Shirani MD., Mohammadreza Asadipanah MD. Wegeneer Granülomatosis Presenting as Wallenberg Syndrome: A Case Report. Journal of Stroke and Cerebrovascular Diseases. Volume 28,Issue 8, August 2019, Pages e107-e109.
17. Wei Qiu, Jing-Shan Wu, William M. Carroll, Frank L. Mastaglia, Allan G. Kermode. Wallenberg Sydrome Caused by Multiple Sclerosis Mimicking Stroke. Journal of Clinical Neuroscience.Volume 16, Issue 12, December 2009,Pages 1700-1702.

Anahtar Kelimeler

Lateral Medullary Syndrome , Wallenberg , Vertebral arteries occlusion

Lateral Medüller Sendrom: Wallenberg

https://izlik.org/JA26DK72ZY

Öz

Özet
Giriş: Lateral Medüller Sendrom (Wallenberg) intrakraniyal patoloji, özellikle de posterior inferior serebellar arter dalının oklüzyonu ile ilişkili ciddi bir nörolojik durumdur. Semptomlar arasında Horner sendromu, ipsilateral yürüme ataksisi ve hipoaljezi ve yüzün ipsilateral termoanestezisi yer alır.
Olgu: 52 yaşında erkek hasta bulantı, kusma ve dengesiz yürüme şikayetleriyle başvurdu. Hasta 4 ay önce kardiyak anjiyoplasti geçirmiş ancak reçete edilen tıbbi tedaviye uymamış ve takip kardiyoloji randevularına gitmemişti. Öğle saatlerinde başlayan semptomları yutma güçlüğü, ses kısıklığı ve hıçkırıkla daha da karmaşık hale gelmiştir. Semptomların başlamasının üzerinden yaklaşık 8 saat geçtiği için trombolitik tedavi uygulanamadı. Hasta ileri değerlendirme için nöroloji servisine yatırıldı.

Sonuç: Lateral Medüller Sendrom (Wallenberg) yaygın ve silik semptomlarla ortaya çıkabilir. Erken hastaneye yatış, özellikle kardiyak anjiyoplasti öyküsü olan hastalar için çok önemlidir, çünkü zamanında müdahale sonuçları iyileştirmek için hayati önem taşıyabilir.

Kaynaklar
1. Neurologic Localization and Diagnosis, Chapter 3.4, 89-106.
2. Netter Collection of Medical İllustration: Nervous system, Part 1 Brain, Section 9,203-254.
3. Dizziness and Vertigo Across the Lifespan. Vertebrobasilar İnfarcts and İschemia. Chapter 16, 191-208.
4. Bradley and Daroff ‘s Neurology in Clinical Practise, 65, 964-1013.e7.
5. Lateral Medullary Syndrome. Alexander Rae-Grant MD, FRCPC,FAAN. Released September 28,2024.
6. A Case Report: Laterally Medullary Syndromewith Facial Nerve Palsy and Hemiparesis. Ramash Shrestha, Ghanshyam Kharel,Sharaddha Acharya, Rohit Pandit and Nitu Limbu. Annals of Medicine and Surgery, 2022-10-01, Volume 82, Article 104722,2022.
7. Basilar Artery Thrombosis and Wallenberg Syndrome in a Patient with Uncontrolled Hypertansion. Nazim Kadaj, Kaltrina Gocaj, Sebeze Kabashi, Kreshnike Dedushi, Vullnet Blakaj and Alba Goçaj. Radiology Case Reports, 2024-08-01, Volume 19, Issue 8, Pages 3033-3037.
8. Papa L, Meurer W. J. Rosen’s Emergency Medicine: Concepts and Clinical Practice,87,1224-1242.e4.2023
9. Aplin P., Mophett. Textbook of Adult Emergency Medicine,8.2,356-364.e1.2020
10. Tomsick T.A., Khatri P., Jovin T., et. al.: Equipoise among recanalization strategies. Neurology 2010; 74: pp. 1069-1076.
11. Biller J, Schneck M J, Ruland S. Bradley and Daroff’s Neurology in Clinical Practice,65,964-1013.e7.2022
12. Pelin Z., Bozluolcay M., Erkol G., Denktaş H., Latreal Medullar Sendromun bir Bulgusu Olarak Hıçkırık ve Tedavisi: Dört Olgu Sunumu. Cerrahpaşa Tıp Dergisi; 32: 115-119. (Pelin Z., Bozluolcay M., Erkol G., Denktaş H., Hiccup and its Treatment as a Manifestation of Lateral Medullary Syndrome: A Presentation of Four Cases. Cerrahpaşa Medical Journal; 32: 115-119.)
13. Park MH., Koh SB.,Park MK., Park KW., Lee DH. Lesional Location of Lateral Medullary İnfaction Presenting Hiccups(singultus). J. Neurol Neurosung Psychiatry.2005;76:95-98.
14. Ubaid Khan, Bilal Ahmad, Ayesha Aslam, Aiman Muhammad, Javed Iqbal. Opalski Syndrome, A Rare Variant of Wallenberg Sydrome, The First Case Report. Heliyon Volume 9, Issue 11, November2023,e21687.
15. Opalski A. A New Sub-bulbar Syndrome: Partial Sydrome of the Posterior Vertebrospinal Artery. Paris Medical 1946;214-20.
16. Maziar Emamikhah WD., Farzad Sina MD., Mahisa Mokhtari MD., Fatemeh Shirani MD., Mohammadreza Asadipanah MD. Wegeneer Granülomatosis Presenting as Wallenberg Syndrome: A Case Report. Journal of Stroke and Cerebrovascular Diseases. Volume 28,Issue 8, August 2019, Pages e107-e109.
17. Wei Qiu, Jing-Shan Wu, William M. Carroll, Frank L. Mastaglia, Allan G. Kermode. Wallenberg Sydrome Caused by Multiple Sclerosis Mimicking Stroke. Journal of Clinical Neuroscience.Volume 16, Issue 12, December 2009,Pages 1700-1702.

Anahtar Kelimeler

Lateral Medüller Sendrom , Wallenberg , Vertebral arterin tıkanması

Kaynakça

• 1. Neurologic Localization and Diagnosis, Chapter 3.4, 89-106.
• 2. Netter Collection of Medical İllustration: Nervous system, Part 1 Brain, Section 9,203- 254.
• 3. Dizziness and Vertigo Across the Lifespan. Vertebrobasilar İnfarcts and İschemia. Chapter 16, 191-208.
• 4. Bradley and Daroff ‘s Neurology in Clinical Practise, 65, 964-1013.e7.
• 5. Lateral Medullary Syndrome. Alexander Rae-Grant MD, FRCPC, FAAN. Released September 28,2024.
• 6. A Case Report: Laterally Medullary Syndromewith Facial Nerve Palsy and Hemiparesis. Ramash Shrestha, Ghanshyam Kharel,Sharaddha Acharya, Rohit Pandit and Nitu Limbu. Annals of Medicine and Surgery, 2022-10-01, Volume 82, Article 104722,2022.
• 7. Basilar Artery Thrombosis and Wallenberg Syndrome in a Patient with Uncontrolled Hypertansion. Nazim Kadaj, Kaltrina Gocaj, Sebeze Kabashi, Kreshnike Dedushi, Vullnet Blakaj and Alba Goçaj. Radiology Case Reports, 2024-08-01, Volume 19, Issue 8, Pages 3033-3037.
• 8. Papa L, Meurer W. J. Rosen’s Emergency Medicine: Concepts and Clinical Practice,87,1224-1242.e4.2023
• 9. Aplin P., Mophett. Textbook of Adult Emergency Medicine,8.2,356-364. e1.2020
• 10. Tomsick T.A., Khatri P., Jovin T., et. al.: Equipoise among recanalization strategies. Neurology 2010; 74: pp. 1069-1076.
• 11. Biller J, Schneck M J, Ruland S. Bradley and Daroff’s Neurology in Clinical Practice,65,964-1013.e7.2022
• 12. Pelin Z., Bozluolcay M., Erkol G., Denktaş H., Latreal Medullar Sendromun bir Bulgusu Olarak Hıçkırık ve Tedavisi: Dört Olgu Sunumu. Cerrahpaşa Tıp Dergisi; 32: 115-119.
• 13. Park MH., Koh SB.,Park MK., Park KW., Lee DH. Lesional Location of Lateral Medullary İnfaction Presenting Hiccups(singultus). J. Neurol Neurosung Psychiatry.2005;76:95-98.
• 14. Ubaid Khan, Bilal Ahmad, Ayesha Aslam, Aiman Muhammad, Javed Iqbal. Opalski Syndrome, A Rare Variant of Wallenberg Sydrome, The First Case Report. Heliyon Volume 9, Issue 11, November2023,e21687.
• 15. Opalski A. A New Sub-bulbar Syndrome: Partial Sydrome of the Posterior Vertebrospinal Artery. Paris Medical 1946;214-20.
• 16. Maziar Emamikhah WD., Farzad Sina MD., Mahisa Mokhtari MD., Fatemeh Shirani MD., Mohammadreza Asadipanah MD. Wegeneer Granülomatosis Presenting as Wallenberg Syndrome: A Case Report. Journal of Stroke and Cerebrovascular Diseases. Volume 28,Issue 8, August 2019, Pages e107-e109.
• 17. Wei Qiu, Jing-Shan Wu, William M. Carroll, Frank L. Mastaglia, Allan G. Kermode. Wallenberg Sydrome Caused by Multiple Sclerosis Mimicking Stroke. Journal of Clinical Neuroscience. Volume 16, Issue 12, December 2009,Pages 1700-1702