Wallenberg's Syndrome
This Malay gentleman presented with 2 days history of dizziness. He cannot walk steadily without assistance.
Examination of the LL shows hemisensory loss up to neck region over RIGHT side. The muscle power is preserved. The propioception is intact. He is ataxic and there is tendency to fall to LEFT side. The heel shin test is impaired over LEFT side.
Further examination shows LEFT facial numbness with intact corneal reflex. There is signs consistent with LEFT Horner's syndrome i.e. partial ptosis and constricted pupil. The 9th and 10th CNs are intact. The eye movement is normal and there is no diplopia.
He has a LEFT lateral medullary syndrome.
Questions:
1. Where is the lesion?
2. What are the other clinical features?
Labels: Neurology
posted by Dr. David Teoh @ 9/14/2006 07:43:00 PM
3 Comments:
why X & IX has spared
Hi sadik,
Not all patients will exhibit the full textbook description of a particular clinical syndrome. In fact, in daily clinical practice, most will present only with a part of the clinical signs listed.
Ya, it is called PICA-like syndrome.
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