Wallenberg's syndrome; lateral medullary syndrome/infarction

Pathology

• brainstem infarction of the lateral medulla oblongata in the distribution of the posterior inferior cerebellar artery (PICA)

Clinical manifestations

• central vertigo*
• nausea/vomiting
• diplopia
• alternating hemianesthesia, contralateral hemianesthesia
• pharyngeal & laryngeal paralysis
• dysphagia
• hoarseness, dysphonia
• ipsilateral cerebellar ataxia, dysmetria & dysdiadokokinesia
• contralateral pain & loss of temperature sensation in extremities
• ipsilateral Horner's syndrome
• ipsilateral facial pain & loss of temperature sensation
  • facial anesthesia
• ipsilateral lower facial paralysis/paresis
• nystagmus

* alternatively, infarction in the distribution of the PICA may result in isolated central vertigo

Differential diagnosis

• cerebellar infarction
  • facial involvement & involvement in pain & temperature pathways distinguish lateral medullary infarction

More general terms

• syndrome
• brainstem infarction

Additional terms

• posterior inferior cerebellar artery
• stroke; cerebrovascular accident (CVA)

Patient information

Wallenberg's syndrome patient information