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Neurology

Question
16 out of 25
 

Lateral medullary syndrome (Wallenberg syndrome) is characterized by all, Except: (AIIMS Nov 2009)



A Giddiness
B Dysphagia

C Crossed hemianesthesia
D Horner’s syndrome is rare

Ans. D

Horner’s syndrome is rare

Lateral Medullary Syndrome

It is due to occlusion of:

1). V4 segment of vertebral artery (Ref. Hari-18th ed., pg- 3288)

2). Post. inf. cerebellar artery (PICA) (VA > PICA)

It is also known as Wallenberg’s syndrome.


Cut section at Medulla

1). This syndrome is characterized by sensory deficits affecting the trunk and extremities on the opposite side of the infarction and sensory deficits affecting the face and cranial nerves on the same side with the infarct.

2). Specifically, there is a loss of pain and temperature sensation on the contralateral (opposite) side of the body and ipsilateral (same) side of the face. This crossed finding is diagnostic for the syndrome

1). On the side of lesion

Symptoms & signs

Structures involved

a. Pain, numbness over half of face

Desc. tract and V nerve nucleus.

b. Ataxia of limb

Cerebellar hemisphere, fibre spinocerebellar tract.

c. Nystagmus, diplopia, vertigo, vomiting

Vestibular nucleus.

d. Horner’s syndrome

Desc. sympathetic tract

e. Dysphagia, hoarseness, gag reflex negative

IX, X nerve.

f. Loss of taste

Nucleus & tractus solitaries.

g. Numbness of arm, trunk, leg

Cuneate & gracile nuclei.

2). On the opposite side

• Impaired pain and thermal sense

Over half of body Spinothalamic tract.

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