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Lateral medullary syndrome

MedGen UID:
53057
•Concept ID:
C0043019
•
Disease or Syndrome
Synonyms: PICA syndrome; Posterior inferior cerebellar artery syndrome; Vertebral artery syndrome; Wallenberg syndrome; Wallenberg's syndrome
SNOMED CT: LMS - Lateral medullary syndrome (78569004); Posterior inferior cerebellar artery syndrome (78569004); Wallenberg's syndrome (78569004); Lateral medullary syndrome (78569004); Inferior cerebellar artery syndrome (78569004)
 
Monarch Initiative: MONDO:0006827

Definition

A syndrome caused by an infarct in the vertebral or posterior inferior cerebellar artery. It is characterized by sensory defects affecting the same side of the face as the infarct and the opposite side of the trunk as the infarct. Patients experience difficulty swallowing and/or speaking. [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVLateral medullary syndrome

Professional guidelines

PubMed

Multimodal treatment of ruptured dissecting aneurysms of the vertebral artery during the acute stage.
Hamada J, Kai Y, Morioka M, Yano S, Todaka T, Ushio Y
J Neurosurg 2003 Dec;99(6):960-6. doi: 10.3171/jns.2003.99.6.0960. PMID: 14705721
Diagnosis and treatment of vertebral aneurysms.
Yamaura A
J Neurosurg 1988 Sep;69(3):345-9. doi: 10.3171/jns.1988.69.3.0345. PMID: 3404230

Recent clinical studies

Etiology

Vascular vertigo and dizziness: Diagnostic criteria.
Kim JS, Newman-Toker DE, Kerber KA, Jahn K, Bertholon P, Waterston J, Lee H, Bisdorff A, Strupp M
J Vestib Res 2022;32(3):205-222. doi: 10.3233/VES-210169. PMID: 35367974Free PMC Article
Lateral Medullary Infarction with or without Extra-Lateral Medullary Lesions: What Is the Difference?
Kang HG, Kim BJ, Lee SH, Kang DW, Kwon SU, Kim JS
Cerebrovasc Dis 2018;45(3-4):132-140. Epub 2018 Mar 20 doi: 10.1159/000487672. PMID: 29558752
Aneurysm of the anterior inferior cerebellar artery-posterior inferior cerebellar artery variant: two case reports and review of literature.
Gopalakrishnan CV, Menon G, Nair S
Br J Neurosurg 2009;23(5):554-6. doi: 10.1080/02688690902987778. PMID: 19669982
Swallowing after lateral medullary syndrome plus.
Robbins J, Levine R
Clin Commun Disord 1993 Fall;3(4):45-55. PMID: 8111364
Wallenberg's syndrome following neck manipulation.
Frumkin LR, Baloh RW
Neurology 1990 Apr;40(4):611-5. doi: 10.1212/wnl.40.4.611. PMID: 2181339

Diagnosis

Vascular vertigo and dizziness: Diagnostic criteria.
Kim JS, Newman-Toker DE, Kerber KA, Jahn K, Bertholon P, Waterston J, Lee H, Bisdorff A, Strupp M
J Vestib Res 2022;32(3):205-222. doi: 10.3233/VES-210169. PMID: 35367974Free PMC Article
Neuroanatomical basis of Wallenberg syndrome.
Gasca-González OO, Pérez-Cruz JC, Baldoncini M, Macías-Duvignau MA, Delgado-Reyes L
Cir Cir 2020;88(3):376-382. doi: 10.24875/CIRU.19000801. PMID: 32539005
Opalski syndrome.
Cheng MY, Sung CY
Acta Neurol Taiwan 2005 Sep;14(3):162-3. PMID: 16252620
Wallenberg's syndrome.
Pearce JM
J Neurol Neurosurg Psychiatry 2000 May;68(5):570. doi: 10.1136/jnnp.68.5.570. PMID: 10766884Free PMC Article
Vertebrobasilar ischemia.
Becker KJ
New Horiz 1997 Nov;5(4):305-15. PMID: 9433983

Therapy

A Case of Wallenberg's Syndrome Presenting with Spontaneous Thrombosis of a Vertebral Artery Aneurysm.
Kamogawa M, Koide T, Kikuchi R, Nakamura A, Tagawa A, Miyazaki H
J Stroke Cerebrovasc Dis 2020 Jan;29(1):104492. Epub 2019 Nov 11 doi: 10.1016/j.jstrokecerebrovasdis.2019.104492. PMID: 31727598
Anti phospholipid syndrome.
Miah MT, Hoque MA, Sutradhar SR, Mahmood T, Tarafder BK
Mymensingh Med J 2009 Jan;18(1):72-4. PMID: 19182754
Chiropractic manipulation: reasons for concern?
Gouveia LO, Castanho P, Ferreira JJ, Guedes MM, Falcão F, e Melo TP
Clin Neurol Neurosurg 2007 Dec;109(10):922-5. Epub 2007 Sep 29 doi: 10.1016/j.clineuro.2007.08.004. PMID: 17904731
Thrombolysis in a case of lateral medullary syndrome: CT angiographic findings.
Khurana D, Saini M, Khandelwal N, Prabhakar S
Neurology 2005 Apr 12;64(7):1232. doi: 10.1212/01.WNL.0000145837.46350.CB. PMID: 15824352
Vertebrobasilar ischemia.
Becker KJ
New Horiz 1997 Nov;5(4):305-15. PMID: 9433983

Prognosis

Dysphagia in Lateral Medullary Syndrome: A Narrative Review.
Jang SH, Kim MS
Dysphagia 2021 Jun;36(3):329-338. Epub 2020 Jul 11 doi: 10.1007/s00455-020-10158-3. PMID: 32654058
Fatal Progression of Gorham-Stout Disease with Skull Base Osteomyelitis and Lateral Medullary Syndrome.
Nozawa A, Ozeki M, Hori T, Kato H, Ohe N, Fukao T
Intern Med 2019 Jul 1;58(13):1929-1933. Epub 2019 Feb 25 doi: 10.2169/internalmedicine.2118-18. PMID: 30799352Free PMC Article
Swallowing after lateral medullary syndrome plus.
Robbins J, Levine R
Clin Commun Disord 1993 Fall;3(4):45-55. PMID: 8111364
Wallenberg's syndrome following neck manipulation.
Frumkin LR, Baloh RW
Neurology 1990 Apr;40(4):611-5. doi: 10.1212/wnl.40.4.611. PMID: 2181339
The lateral medullary (Wallenberg) syndrome: clinical features and prognosis.
PETERMAN AF, SIEKER TR
Med Clin North Am 1960 Jul;44:887-96. doi: 10.1016/s0025-7125(16)33976-1. PMID: 14432178

Clinical prediction guides

Clinical and Radiological Characteristics Associated with Respiratory Failure in Unilateral Lateral Medullary Infarction.
Pavšič K, Fabjan A, Zgonc V, Šurlan Popović K, Pretnar Oblak J, Bajrović FF
J Stroke Cerebrovasc Dis 2021 Sep;30(9):105947. Epub 2021 Jun 27 doi: 10.1016/j.jstrokecerebrovasdis.2021.105947. PMID: 34192618
Lateral Medullary Syndrome Following Injury of Lateral Vestibulospinal Tract: Diffusion Tensor Imaging Study.
Jang SH, Oh S, Yeo SS
J Stroke Cerebrovasc Dis 2020 Nov;29(11):105252. Epub 2020 Aug 28 doi: 10.1016/j.jstrokecerebrovasdis.2020.105252. PMID: 33066903
Measurement of horizontal ocular deviation on magnetic resonance imaging in various disease with acute vertigo.
Yang YJ, Choi JE, Kim MT, Kim SH, Lee MY, Yoo DS, Jung JY
PLoS One 2019;14(10):e0224605. Epub 2019 Oct 31 doi: 10.1371/journal.pone.0224605. PMID: 31671145Free PMC Article
Lateral Medullary Infarction with or without Extra-Lateral Medullary Lesions: What Is the Difference?
Kang HG, Kim BJ, Lee SH, Kang DW, Kwon SU, Kim JS
Cerebrovasc Dis 2018;45(3-4):132-140. Epub 2018 Mar 20 doi: 10.1159/000487672. PMID: 29558752
Crossed cheiro-oral syndrome.
Chen WH, Li TH, Chen TH, Lin HS, Hsu MC, Chen SS, Liu JS
Clin Neurol Neurosurg 2008 Dec;110(10):1008-11. Epub 2008 Jul 30 doi: 10.1016/j.clineuro.2008.06.013. PMID: 18667266

Recent systematic reviews

Opalski syndrome: A comprehensive systematic review of cases.
Rezaei Zadeh Rukerd M, Mirkamali H, Alizadeh SD
Clin Neurol Neurosurg 2024 Oct;245:108474. Epub 2024 Jul 31 doi: 10.1016/j.clineuro.2024.108474. PMID: 39096581
The association between contraversive lateropulsion and outcomes post stroke: A systematic review.
Nolan J, Godecke E, Singer B
Top Stroke Rehabil 2022 Mar;29(2):92-102. Epub 2021 Mar 1 doi: 10.1080/10749357.2021.1886640. PMID: 33648434

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