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lateral medullary syndrome
ICD-10 Codes
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Description
Based on the search results, here is a summary of the description of Lateral Medullary Syndrome (LMS), also known as Wallenberg's Syndrome:
Definition: Lateral Medullary Syndrome (LMS) is a neurological condition caused by an occlusion (blockage) of the vertebral artery or posterior inferior cerebellar artery, leading to infarction (death) of the lateral medulla oblongata.
Symptoms:
- Ipsilateral ataxia (difficulty with coordination and balance on the same side as the lesion)
- Contralateral hypalgesia (loss of pain sensation on the opposite side of the body)
- Horner's syndrome (ptosis, miosis, and anhidrosis on the same side as the lesion)
- Vertigo
- Dysphagia (difficulty swallowing)
- Dysarthria (speech difficulties)
Causes: The most common cause is a blockage of the vertebral artery or posterior inferior cerebellar artery.
Recovery: Most patients with LMS recover well, and many resume their previous level of functioning.
Additional Characteristics
- Dysphagia
- Horner's syndrome
- Dysarthria
- Vertigo
- Ipsilateral ataxia
- Contralateral hypalgesia
Signs and Symptoms
Common Signs and Symptoms of Lateral Medullary Syndrome
Lateral medullary syndrome, also known as Wallenberg syndrome or posterior inferior cerebellar artery syndrome, is a neurological disorder that can cause a range of symptoms due to ischemia in the lateral part of the medulla oblongata. The most common signs and symptoms include:
- Sensory symptoms & signs: These occur in up to 96% of all lateral medullary infarct patients, including loss of pain and temperature sensation on one side of the face, hemisensory loss on the contralateral trunk, and sensory ataxia [1][2].
- Gait ataxia: This is a common symptom, often accompanied by dizziness and vertigo [3].
- Dysphagia: Difficulty swallowing can occur due to damage to the nerves controlling the muscles involved in swallowing [4].
- Hoarseness: A nasal voice or hoarseness can be caused by damage to the nerves controlling the vocal cords [5].
- Vertigo and nystagmus: These symptoms are often present, indicating problems with balance and coordination [6][7].
- Nausea and vomiting: These can occur due to the body's response to the ischemia [8].
Other Possible Symptoms
In addition to these common symptoms, other possible signs of lateral medullary syndrome include:
- Loss of pain and temperature sensation on one side of the face
- Hemisensory loss on the contralateral trunk
- Sensory ataxia
- Dysarthria: Difficulty speaking or slurred speech
- Ptosis: Drooping eyelid
- Miosis: Pupil constriction
It's essential to note that not everyone with lateral medullary syndrome will experience all of these symptoms, and the severity can vary from person to person. If you suspect you or someone else may be experiencing symptoms of this condition, it's crucial to seek medical attention promptly.
References:
[1] Refers to symptom mentioned in search results #1 [2] Refers to symptom mentioned in search results #2 [3] Refers
Additional Symptoms
- Nausea and vomiting
- Sensory ataxia
- Gait ataxia
- Vertigo and nystagmus
- Sensory symptoms & signs
- Loss of pain and temperature sensation on one side of the face
- Hemisensory loss on the contralateral trunk
- dysarthria
- ptosis
- dysphagia
- miosis
- hoarseness
Diagnostic Tests
Lateral medullary syndrome, also known as Wallenberg syndrome, can be diagnosed using various diagnostic tests.
- MRI with diffusion-weighted imaging (DWI) is considered the best diagnostic test to confirm the infarct in the lateral medulla [4][6]. This test tracks the movement of water in the brain and can help establish a diagnosis.
- Computed Tomography (CT) scans may also be used, although they are not as sensitive as MRI for detecting small infarcts [3].
- Magnetic Resonance Imaging (MRI) with or without DWI is essential to determine the extent of the infarct and rule out other potential causes of symptoms [7][10].
- Angiography, including Computed Tomography Angiography (CTA) and Magnetic Resonance Angiography (MRA), can be used to visualize the blood vessels and confirm the presence of a vascular event [7][13].
- Clinical examination is also crucial in diagnosing lateral medullary syndrome, as it involves assessing symptoms such as vertigo, difficulty standing and walking, sensory loss on the ipsilateral side of the face, and other neurological signs [2][5].
These diagnostic tests can help confirm a diagnosis of lateral medullary syndrome and rule out other potential causes of symptoms.
Additional Diagnostic Tests
- Magnetic Resonance Imaging (MRI)
- Clinical examination
- Computed Tomography (CT) scans
- Angiography
- MRI with diffusion-weighted imaging (DWI)
Treatment
Treatment Options for Lateral Medullary Syndrome
Lateral medullary syndrome, also known as Wallenberg syndrome, is a neurological condition that requires prompt medical attention. While there are no specific medications to cure the condition, various treatments can help alleviate symptoms and improve quality of life.
- Pain Management: Pain is a common symptom of lateral medullary syndrome. Medications such as gabapentin may be prescribed to reduce or eliminate pain [5].
- Speech/ Swallowing Therapy: Speech therapy can help patients with difficulty swallowing, while also improving communication skills.
- Anti-epileptic Drugs: In some cases, anti-epileptic drugs like gabapentin may be used to manage symptoms [5].
Emergency Treatment
In the event of a stroke or vascular event leading to lateral medullary syndrome, emergency treatment is crucial. This may involve resuscitation followed by monitoring in an intensive care unit [7]. Restoring blood flow to the affected area is essential.
Rehabilitation and Therapy
Therapy should focus on functional skills, balance therapy, and habituation exercises to reduce vertigo [9]. A multidisciplinary approach involving healthcare professionals from various fields can help patients recover and adapt to their condition.
It's essential to note that treatment for lateral medullary syndrome is dependent on how quickly it is identified. Prompt medical attention and a comprehensive treatment plan can significantly improve outcomes [6].
References:
[5] - Treatment for Wallenberg's syndrome focuses on easing the symptoms of the disorder. [6] - Treatment for lateral medullary syndrome involves focusing on relief of symptoms and active rehabilitation to help patients return to their daily activities. [7] - Emergency treatment: This may involve resuscitation followed by monitoring in an intensive care unit. [9] - Therapy should involve functional skills, balance therapy, and habituation exercises to reduce vertigo.
Recommended Medications
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Differential Diagnosis
Lateral medullary syndrome (LMS), also known as Wallenberg syndrome, has a differential diagnosis that includes various conditions that can present with similar symptoms.
Conditions to Consider:
- Hemorrhagic stroke: This condition involves bleeding in the brain and can cause symptoms similar to LMS, such as difficulty swallowing, slurred speech, and facial pain [7].
- Multiple sclerosis: This is an autoimmune disease that affects the central nervous system and can cause a range of neurological symptoms, including those seen in LMS [8].
- Labyrinthitis: This condition involves inflammation of the inner ear and can cause vertigo, difficulty swallowing, and other symptoms similar to LMS [9].
- Middle cerebral artery syndrome: This is a type of stroke that affects the middle part of the brain and can cause symptoms such as weakness or numbness in one side of the body, which may be confused with LMS [10].
- Migraine: Some people experience aura symptoms before a migraine headache, which can include vertigo, difficulty swallowing, and other neurological symptoms similar to LMS [11].
Key Points to Consider:
- Difficulty swallowing (dysphagia) is a common symptom of LMS, but it can also be seen in conditions such as labyrinthitis and multiple sclerosis.
- Vertigo and balance problems are also common in LMS, but they can be caused by other conditions such as middle ear problems or inner ear disorders.
- Facial pain and numbness are symptoms that can be seen in LMS, but they can also be caused by other conditions such as trigeminal neuralgia.
References:
[7] - According to search result 7, hemorrhagic stroke is a condition that involves bleeding in the brain and can cause symptoms similar to LMS. [8] - Search result 8 mentions multiple sclerosis as an autoimmune disease that affects the central nervous system and can cause a range of neurological symptoms, including those seen in LMS. [9] - Search result 9 notes that
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