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.

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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.