What is Wallenberg Syndrome & How is it Treated?|Causes, Symptoms, Prevention of Wallenberg Syndrome

Wallenberg syndrome is a condition in which there is infarction or stroke in the lateral medulla that is a part of the brain stem. If the arteries that lead to this part of the brain get deprived of the oxygenated blood. Stroke can occur due to blockage. Wallenberg syndrome is also termed lateral medullary infarction. It can lead to temporary or long-term neurological problems.⁽¹⁾

Why this type of stroke occurs is yet to be figured out by the researchers. However, there is some connection observed between artery disease, heart disease, blood clots, minor neck trauma from rotational activities, and Wallenberg syndrome. Minor neck trauma is common in those who are 45 years or younger.

The cause of Wallenberg syndrome include: ⁽¹⁾

• Cerebral embolism
• Marfan syndrome
• Vertebral artery dissection which is the neck manipulation or neck injury
• Fibromuscular dysplasia

The risk factors of Wallenberg syndrome include diabetes, smoking, and hypertension.

It is important to mention these symptoms if any person has them in history.

The brain stem delivers the messages to the spinal cord for motor and sensory functions. If a stroke occurs in this area the muscle sensation and messages perceived are affected. People with Wallenberg syndrome have dysphagia or difficulty in swallowing, which is the most common symptom of this condition. Wallenberg syndrome can worsen depending on the nutrition a person is getting. The other symptoms of Wallenberg syndrome are:⁽²⁾

• Nausea
• Hiccups
• Decrease in sweating
• Hoarseness
• Difficulty in walking
• Dizziness
• Difficulty in maintaining balance
• Nystagmus or rapid eye movement
• Problems with the temperature sensation

Some people with Wallenberg syndrome also experience paralysis in one part of the body including the limbs, face, and also the tongue. The difference is also felt in how hot and cold sensation is there on one side of the body. Some people walk in a slanting posture as everything seems tilted to them or off balance.

Wallenberg syndrome can also lead to bradycardia i.e. slow heart rate. It can also make the blood pressure fluctuate. The condition can complicate to aspiration pneumonia, deep vein thrombosis, heart attack, lung infection, and pulmonary embolism. ⁽⁴⁾

For diagnosing Wallenberg syndrome, the doctor looks for the person’s health history and symptoms. A CT scan or MRI is recommended if the Wallenberg syndrome is suspected. This can help in confirming whether there is a block in the artery near the lateral medulla. ECG is done to rule out atrial fibrillation or acute coronary artery syndrome.

No specific treatment is available for Wallenberg syndrome. The main focus of the treatment is to provide relief from the symptoms, reduce the size of the infarction and prevent any medical complication.

• Speech and swallow therapy is recommended as that helps in learning to swallow again. In severe cases, a feeding tube is recommended as it can help in getting the deficient nutrients.
• Pain medications are prescribed to relieve chronic pains. Blood thinners are also prescribed to reduce or dissolve a blockage in the arteries. This can also prevent further blood clots from forming. To some people, anti-epileptic or anti-seizure medications are prescribed as they help with the symptoms.
• The blood sugar is maintained at normal levels by either lifestyle changes or medications.
• Surgery is an option for cases where the severity level is too high. This option is not common as getting to that area of the brain is difficult.

A healthy lifestyle can help in preventing this stroke from occurring and this can be obtained in the following ways:

• Control the blood pressure levels
• Reduce the amount of cholesterol and saturated fats from the diet
• Quit tobacco usage
• Maintain blood sugar level with lifestyle change and medications
• Maintain a healthy weight
• Exercising regularly
• Moderate alcohol consumption
• Avoid illegal drugs
• Get treated for obstructive sleep apnea

The outlook of Wallenberg syndrome is positive. The recovery depends on where the stroke occurred (in which part of the brain) and how much brain damage has occurred. ⁽³⁾ Some people with Wallenberg syndrome recover in a few weeks of the treatment while a few may have permanent disabilities. It is important to discuss all the symptoms and medical history with the doctor and also the long-term outlook. Following the treatment plan is also important for a full recovery from Wallenberg syndrome.

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