Lateral medullary syndrome

Some survivors of a Vertebral Arterial Dissection may go on to live life with some degree of Lateral Medullary Syndrome.

Also called “Wallenbergs Syndrome” this syndrome is not limited to survivors of brain injury alone, but for the purpose of this booklet, that is the only area being discussed.

Signs and symptoms

• This syndrome is characterized by

• Sensory deficits that affect the trunk and extremities contralaterally.

  • If your injury was on the left side of your brain, your right side will have sensory deficits.

  • Conversely you can tell which side of the brain was affected by noticing which side of your body (from your shoulders down) has sensory deficits.

• Deficits include lack of feeling HOT, COLD, PINCH from a needle, PIN or nail.

• General Lower body temperature

• Lower Strength and coordination

• Loss of ‘tickle effect’

• One oddity is the deficit generally shifts sides at your neck and affects various spots all over your face and head, favoring the opposite side of your body deficits.

• Balance and difficulty walking, wide gait, fear of steps, over-leaning to one side or the other.

  • Many of these are vestibular, Nystagmus (eye-shaking), eyes not teaming, or pupils dilated at different sizes.

  • Other balance issues are a combination of vestibular and damage to the balance center of the brain.

• Nucleus ambiguus - (which affects vagus nerve and glossopharyngeal nerve) - dysphagia, hoarseness, absent gag reflex

  • Difficulty Swallowing

• Maintaining full intellectual skills, but having severe difficult expressing intellect through speech. Often out performs at writing, but can be very insecure in speaking.

• Constant 24/7 pain, mostly through affected side. Although nerves have become insensitive to most external stimuli (handling a hot cup, feeling a cut or impalement), the nerves appear to be in a constant and painful misfire of their own.

• Mood swings and emotional outburst (crying, anger) due to damage to the amygdala)

According to Wikipedia, lateral medullary syndrome is the most common form of posterior ischemic stroke syndrome. They estimated around 600,000 new cases of this syndrome in the United States alone