1991 Volume 50 Issue 3 Pages 298-304
For 48 months since 1986, a male patient in his early 60 s has been treated for Wallenberg's syndrome, we report our otoneurological and roentgenological findings.
Rotatory nystagmus is often found in medullary disturbances. In this case pure rotatory nystagmus to the affected left side was observed in the early stage, which then gradually moved up and down diagonally to different positions. In Wallenberg's syndrome, it is indeed difficult to predict the exact type of nystagmus because of variable symptoms in different types of disturbances.
Electronic nystagmography (ENG) improved at 8 months and angiography confirmed by-pass circulation to the affected side at 24 months. It seemed that the by-pass had been completed at 8 months, at the time of the improvement in ENG.
Urokinase administration proved helpful in this case, but it must be applied with great care because of the danger of bleeding cerebral disease.
ENG examinations and otoneurological finding were decisive in establishing an early diagnosis.
