Wallenberg’s Syndrome (known medically as “lateral medullary syndrome”) is a condition which affects the central nervous system.
Causes & Risk Factors
Wallenberg’s Syndrome is usually caused by a stroke, which takes place in the brain stem.
The affected cells and nerves then die due to lack of oxygen. And the dying brain cells and nerves are the cause of the symptoms in the specific areas they control.
The symptoms can also be caused or influenced by many other disorders, including:
- head or neck injuries
- inflammation of the wall of the artery in the neck
- hematoma, or an abnormal blood clot
- brain stem encephalitis due to herpes
- multiple sclerosis
- brain stem tuberculoma, which is a rare form of tuberculosis
- certain infections, such as varicella (chickenpox) infection
Although it’s not yet completely clear, it seems that some people may be more at risk for Wallenberg’s Syndrome than others.
➡ People with a history of blood clots, heart disease, smoking, pregnancy, a recent delivery and circulation problems may be more at risk.
➡ And it’s possible that other disorders such as multiple sclerosis, herpes, and cancer may also put a person at greater risk for Wallenberg’s syndrome.
When oxygen-rich blood is blocked to parts of the brain stem, due to a stroke or other condition, many symptoms, such as trouble swallowing can happen.
Treatment usually focuses on reducing or improving the symptoms, but the long-term outlook varies greatly.
➡ It controls the flow of messages and chemical signals between the brain and your body parts.
➡ It affects your basic body functions, such as swallowing, breathing, and heart rate.
➡ It also controls how “conscious,” (awake or asleep) a person feels.
Without adequate blood flow and oxygen in the brain stem, serious problems happen throughout the body, including Wallenberg’s syndrome.
As mentioned earlier, difficulty swallowing is a common symptom. Some people may not be able to swallow at all.
It can also cause problems with how the muscles respond to commands it receives from the brain. Loss of the sense of touch is an example.
Other symptoms of Wallenberg’s Syndrome may include:
- difficulty breathing
- difficulty speaking
- severe, persistent hiccups
- hoarse voice
- rapid eye movements in many directions
- trouble maintaining or loss of balance, falling
- changes in the sensation of body temperatures, such as hot flashes or chills
- reduced sweating
Wallenberg’s Syndrome may also be the cause of more unusual symptoms:
- Neurological changes, such as feeling colder, feeling pain, stinging or complete numbness on one side of the body may be present.
- Patients have reported feeling that the world around them is “off balance” or that things seem to be tilting towards one side of the room.
- Drastic changes in heart rate or blood pressure can happen.
After reviewing the symptoms, as reported by the patient, a thorough neurological examination is called for as well as some type (s) of imaging tests of the brain stem such as a CT Scan or MRI.
- These imaging tests give an exact view of the inside of the body, making it easier to find a block in the arteries and damage to the brain stem.
There is no simple cure for Wallenberg’s syndrome.
The goal of treatment is to lessen the symptoms as much as possible while managing the ones that cannot be resolved. Understanding the cause of the symptoms is a necessary step.
Therapy and rehabilitation play an important part when treating Wallenberg’s syndrome.
- A referral to a speech therapist may be required if the patient is having trouble moving their mouth, speaking or having trouble swallowing.
- In severe situations, if a patient is not able to swallow, swallowing therapy and a feeding tube may be necessary.
Certain medications may also be prescribed. For instance, if a clot-forming stroke caused the symptoms, blood thinners may be prescribed to help break up or dissolve any blockage in the artery that has caused the damage.
In addition, blood thinners may cut the risk of future blood clots.
➡ A low dose of aspirin, for instance, may be prescribed to cut the chances of another stroke.
➡ Other medications may include pain management drugs, for long-lasting or chronic pain.
➡ Depending on their symptoms, some people may benefit from taking anti-seizure, anticonvulsants, or anti-epileptic drugs.
One of the more difficult symptoms to treat is persistent hiccups, which is commonly seen with Wallenberg’s Syndrome.
➡ They can be violent and painful at times and may make it difficult for a person to eat, speak, or even sleep.
➡ They may last for days or weeks at a time.
Certain muscle relaxers may be able to help patients with chronic hiccups, but treatment can be difficult.
The outlook for Wallenberg’s syndrome varies from person to person. It largely depends on the size and cause of the stroke.
- Symptoms will vary depending on how much of the lateral medulla has been damaged.
Some people see a decrease in their symptoms in the months following a stroke as the brain recovers, while others may be left with neurological disabilities for years after the first stroke.
However, other causes may affect how long symptoms last. This and the long-term outlook should be openly discussed with the doctor.
As with most medical conditions, following through with the prescribed treatment plan will give the patient the best possible tools for recovery.
- If you or a loved one is suffering symptoms similar or the same as those described above, please make an appointment to see your primary physician as soon as possible.
If you, a family member or friend has been diagnosed with Wallenberg’s Syndrome and need more support or information, please contact any of the agencies listed below:
Organizations that support research and outreach for Wallenberg’s Syndrome include:
- The National Institute of Neurological Disorders and Stroke (NINDS)
- National Stroke Association
- American Heart Association