Lateral medullary syndrome

Background

• Also known as Wallenberg syndrome, PICA syndrome
• Caused by occlusion of the posterior inferior cerebellar artery (PICA)
  • Can also be caused by occlusion of the vertebral artery at the origin of PICA

Clinical Features

• Contralateral loss of pain and temperature sensation to body
• Ipsilateral loss of pain and temperature sensation to face
• Dysphagia, soft palate paralysis, hoarseness, diminished gag reflex
• Ipsilateral Horner syndrome
• Nausea, diplopia, patient that is falling to the ipsilateral side, nystatmus, vertigo
• Ataxia to the ipsilateral side