Wallenberg's syndrome

Wallenberg’s syndrome is a neurological condition caused by a stroke in the vertebral or posterior inferior cerebellar artery of the brain stem.

Wallenberg infarct

Symptoms

Symptoms include difficulties with swallowing, hoarseness, dizziness, nausea and vomiting, rapid involuntary movements of the eyes (nystagmus), and problems with balance and gait coordination.

Atypical symptoms

• Some individuals will experience a lack of pain and temperature sensation on only one side of the face, or a pattern of symptoms on opposite sides of the body – such as paralysis or numbness in the right side of the face, with weak or numb limbs on the left side.
• Uncontrollable hiccups may also occur, and some individuals will lose their sense of taste on one side of the tongue, while preserving taste sensations on the other side.
• Some people with Wallenberg’s syndrome report that the world seems to be tilted in an unsettling way, which makes it difficult to keep their balance when they walk.

Prognosis

• Prognosis depends on the area of the brain stem that is affected including the size and location of the area of the brain stem damaged by the stroke.
• While some individuals may see a decrease in their symptoms within weeks or months.
• Others may be left with significant neurological disabilities for years after the initial symptoms appeared.

Treatment

• Treatment for Wallenberg's syndrome is symptomatic.
• A feeding tube may be necessary if swallowing is very difficult.
• Speech/swallowing therapy may be beneficial. In some cases, medication may be used to reduce or eliminate pain.
• Anti-epileptic drug gabapentin appears to be an effective medication for individuals with chronic pain.