Résumé
We studied three patients who developed left unilateral punctate keratitis after suffering left-sided Wallenberg Syndrome. A complex evolution occurred in two of them. In all cases, neurophysiological studies showed damage in the trigeminal sensory component at the bulbar level. Corneal involvement secondary to Wallenberg syndrome is a rare cause of unilateral superficial punctate keratitis. The loss of corneal sensitivity caused by trigeminal neuropathy leads to epithelial erosions that are frequently unobserved by the patient, resulting in a high risk of corneal-ulcer development with the possibility of superinfection. Neurophysiological studies can help to locate the anatomical level of damage at the ophthalmic branch of the trigeminal nerve, confirming the suspected etiology of stroke, and demonstrating that prior vascular involvement coincides with the location of trigeminal nerve damage. In some of these patients, oculofacial pain is a distinctive feature.
Sujets)
Sujet âgé , Femelle , Humains , Adulte d'âge moyen , Cornée/anatomopathologie , Diagnostic différentiel , Kératite/diagnostic , Syndrome de Wallenberg/complicationsRésumé
Descrevemos um caso de síndrome bulbar lateral, também conhecida pelo epônimo síndrome de Wallenberg, em uma paciente do sexo feminino de 46 anos, com todos os sinais e sintomas clássicos, determinada por aneurisma gigante do segmento intracraniano da artéria vertebral. A síndrome de Wallenberg, apesar de comum a sua apresentação como consequência de aneurisma gigante de artéria vertebral, não é frequente, e na patogênese da sintomatologia o efeito de massa dessas lesões deve ser considerado.
We present a case of lateral bulbar syndrome, or Wallenbergïs syndrome, in a 46 year-old woman with all classic signs and symptoms, due to giant aneurysm of the vertebral artery at its intracranial segment. Even though common, Wallenberg syndrome due to giant aneurysm is not frequent, and in its pathogenesis the mass effect of this lesions may have a significant role.