This syndrome was first described in 1808 by Gaspard Vieusseux. Others may be left with significant neurological disabilities for years after the initial symptoms appeared. Some individuals may see a decrease in their symptoms within weeks or months. The outlook for someone with lateral medullary syndrome depends upon the size and location of the area of the brain stem damaged by the stroke. Some doctors report that the anti-epileptic drug gabapentin appears to be an effective medication for individuals with chronic pain. In some cases, medication may be used to reduce or eliminate pain. Speech/swallowing therapy may be beneficial. A feeding tube may be necessary if swallowing is very difficult. Treatment for lateral medullary syndrome is symptomatic. Onset is usually acute with severe vertigo. Nystagmus and vertigo, which may result in falling, caused from involvement of the region of Deiters' nucleus and other vestibular nuclei. The damage to the cerebellum or the inferior cerebellar peduncle can cause ataxia. The spinothalamic tract is damaged, resulting in loss of pain and temperature sensation to the opposite side of the body. Damage to the spinal trigeminal nucleus causes absence of pain on the ipsilateral side of the face, as well as an absent corneal reflex. The affected persons have difficulty in swallowing ( dysphagia) resulting from involvement of the nucleus ambiguus, and slurred speech ( dysphonia, dysarthria). The cause of this syndrome is usually the occlusion of the posterior inferior cerebellar artery (PICA) at its origin. Other clinical symptoms and findings are ataxia, facial pain, vertigo, nystagmus, Horner's syndrome, diplopia and dysphagia. This syndrome is characterized by sensory deficits affecting the trunk and extremities on the opposite side of the infarct and sensory and motor deficits affecting the face and cranial nerves on the same side with the infarct. Nucleus ambiguus (which affects vagus X and glossopharyngeal nerves IX)ĭysphagia, hoarseness, diminished gag reflexĪn affected person may present with ataxia on the side of lesion. Ipsilateral loss of pain and temperature sensation from face Lateral medullary syndrome presents with the following symptoms:Ĭontralateral deficits in pain and temperature sensation from body It is the clinical manifestation resulting from occlusion of the posterior inferior cerebellar artery (PICA) or one of its branches or of the vertebral artery, in which the lateral part of the medulla oblongata infarcts, resulting in a typical pattern.
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