2001 Volume 5 Issue 1 Pages 3-10
Purpose
We studied the clinicoradiological characteristics of patients with Wallenberg syndrome by lateral medullary infarction．
Method
Seventeen patients with Wallenberg syndrome were divided into a normal group（N）and dysphagia group（D）according to the results of a water swallowing test．We examined for the following 7 symptoms： vertigo or dizziness，gaze nystagmus，cerebellar ataxia，dissociated sensory loss including the range from Hayakawa's classification，Horner's syndrome，hoarseness and hiccups．Magnetic resonance imaging（MRI）was done within 7 days of the first neurological examination．Lesions were located in 3 parts，classified into the rostral， middle and caudal portions．
Results
7 patients belonged to group N and 10 patients belonged to group D，and 59％ of the patients showed dysphagia． All patients showed vertigo or dizziness， gaze nystagmus， cerebellar ataxia and dissociated sensory loss． All cases of Horner's syndrome（57％ of group N and 90％ of group D），hoarseness（29％ of group N and 90％ of group D），and hiccups（43％ of group N and 80％ of group D） were more frequent in group D，and hoarseness was the only statistically frequent clinical symptom．Only 1 patient in group N and 7 patients in group D showed all 7 symptoms．Of the 7 patients in group N，3 were placed in Hayakawa class 1 and 4 in Hayakawa class IV．Meanwhile，7 of the 10 patients in group D were placed in Hayakawa class 1 and the other 3 in Hayakawa class ll ． Radiologically，the lesions were located in the middle portion in 3 patients in group N and in the caudal portion in the other 4 patients．ln group D，the lesions were located in the rostral portion in 5 patients and the middle portion in 5 patients．
Conclusions
The more symptoms appeared，the more often the swallowing functions were disturbed in patients with Wallenberg syndrome．Hoarseness was the symptom most related to dysphagia．Of the patients exhibiting lateral medullary infarctions，dysphagia was more common in patients with infarctions in the rostral portion of the medulla．
