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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. Oxygenated blood doesn’t get to this part of the brain when the arteries that lead to it are blocked. A stroke can occur due to this blockage. This condition is also sometimes called lateral medullary infarction. The cause of the syndrome isn’t always clear, however.
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’re getting. Other symptoms include:
Sometimes, 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 people will walk at a slant or report that everything around them seems tilted or off balance.
The syndrome can also cause bradycardia, or a slow heart rate, and low or high blood pressure. Discuss any symptoms you have with your doctor. Every bit of information can help them make a diagnosis.
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 people younger than 45. You should tell your doctor if you have a history of any of these problems.
A doctor will usually make a diagnosis after carefully reviewing a person’s health history and listening to their description of the symptoms. You may need to undergo a CT scan or MRI if your doctor suspects that you have Wallenberg syndrome. They can order these imaging studies to confirm whether or not there is a block in the artery near the lateral medulla.
No cure is available for this condition, but your doctor will probably focus treatment on relieving or eliminating your symptoms. They may prescribe speech and swallowing therapy to help you learn to swallow again. They may also recommend a feeding tube if your condition is severe. This can help provide you with the nutrients you need.
Your doctor may prescribe medication. Pain medication can help treat chronic or long-lasting pain. Alternatively, they may prescribe a blood thinner, such as heparin or warfarin, 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 antiseizure drug called gabapentin can help with your symptoms.
Surgery may be an option to remove the clot in extreme cases. This is not as common of a treatment due to the difficulty of getting to that area of the brain.
Make sure to discuss your treatment options with your doctor and follow the plan carefully.
The long-term outlook for people with Wallenberg syndrome is fairly positive. A successful recovery depends on where the stroke happened in the brainstem. It also depends on 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 doctor if you have any questions. Be sure to follow your treatment plan carefully to ensure your best chances for a full recovery.
Written by: Tricia Kinman
Medically reviewed on: Aug 08, 2016: University of Illinois-Chicago, College of Medicine
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