Wallenberg's syndrome

Alternative eponyms

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A complex of symptoms caused by occlusion of the posterior inferior cerebellar artery, resulting in sensory and sympathetic disturbances, cerebellar and pyramidal tract signs, etc.

Description

A complex of symptoms caused by occlusion of the posterior inferior cerebellar artery or one of its branches supplying the lower portion of the brain stem, resulting in sensory and sympathetic disturbances, cerebellar and pyramidal tract signs, and evidence of partial involvement of the fifth, ninth, tenth, and eleventh cranial nerves.

Onset is usually acute with severe vertigo due to involvement of the region of Deiter's nucleus, which may result in falling. Nausea, vomiting, ipsilateral ataxia, mucular hypertonicity, pastpointing, lateropulsion, and other cerebellar signs are often present. Pain and facial paresthaesia, a coarse spontaneous homolateral nystagmus, hiccough, dysphagia, dysphonia, dysarthria, and diplopia may be evident. Horner's syndrome is usually present. Sensory disturbances include ipsilateral loss of pain and temperature perception of the face and contralateral hypoesthaesia for pain and temperature of the trunk and extremities. The affected persons have difficulty in swallowing. Persons well over 40 years of age are most often affected.

It was first described in 1808 by the Geneva physician Gaspard Viesseux (1746-1814), who rendered an exact description of his own disease at a meeting of the Société médicochirugicale de Genève. Olivier and de Morsier in the archives of this society found a report written by Gaspard Viessueux that they published in 1943. The case was published by Alexandre John Gaspard Marcet (1770-1824) in London in 1811 after Viesseux had visited London and reported of his disease there. First description by Wallenberg in 1895 (clinical) and 1901 (autopsy findings).

Bibliography

  • A. Marcet:
    A chemical account of various dropsial fluids etc.
    Medico-Chirurgical Transactions, 1811, 2: 215.
    The title is not certain.
  • A. Wallenberg:
    Acute Bulbäraffection (Embolie der Arteria cerebelli posterior inferior sinistra?).
    Archiv für Psychiatrie und Nervenkrankheiten, Berlin, 1895, 27: 504-540. Anatomischer Befund ein einem als «acute Bulbäraffection (Embolie der Arteria cerebelli posterior inferior sinistra.)» beschriebenen Falle.
    Archiv für Psychiatrie und Nervenkrankheiten, Berlin, 1901, 34: 823.
  • J. Olivier, G. de Morsier, in:
    Revue médicale de la Suisse romande, Lausanne, 1943, 63: 421.

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