A Clinical Study of 21 Patients with Lateral Medullary Syndrome

ABSTRACT

We reviewed clinicoradiologic findings of twenty-one patients with lateral medullary(Wallenberg) syndrome who admitted at Seoul National University Hospital from March, 1983 to February, 1989. The results are as follows: 1. Lateral medullary syndrome was 14.6% of ischemic stroke in vertebrobasilar territory during the same period. The ages ranged from 35 to 69 years and most of them were in 6th or 7th decades. Z. Detected risk factors were hypertension in 17, previous stroke in 8, hyperlipidemia in 7, and diabetes mellitus in 4. 3. The interval which developed maximal characteristic symptoms after onset were within 5 days in all patients and 2 days in 13 patients. 4. Frequent complaints were dizziness in 21, vertigo in 17, nausea or vomiting in 18, swallowrng difficulty in 14, dysarthria in 12, headache in 11, hoarseness in 7, hiccup in 7, and facial pain in 3, 5. Frequent signs were Horner's syndrome in 21, ataxia in 21, crossed sensory change in 19, soft palate sagging in 15, ipsilateral facial weakness in 9, DTR increase in the same side in 7, tongue deviation in 6, transient diplopia in 5, and transient altered consciousness in 4, 6. Disease courses were considerable improvement in 18, recurrence in 1, and discharge against medical advice in 1. Frequent disturbing complaints during the follow-up period were paresthesia or sensory loss in 16 and ataxia in 11. 7 Among the radiologic studies, MRI could define the lesion at corresponding site in 8 of 9, CT in 3 of 21, and TFCA in 3 of 6. These results suggest that MRI is the best rdiologic study to yeild the lesion in lateral medullary syndrome.