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Published in Anton Sebastian, A Dictionary of the History of Medicine, 2018
Wallenberg Syndrome Ipsilateral loss of pain and temperature sensations in the face, with contralateral hypoesthesia for pain and temperature of the trunk due to occlusion of the posterior inferior cerebellar artery. Described in 1895 by German neurologist, Adolf Wallenberg (1862–1949) at Berlin.
Neurological and neuromuscular disorders of the larynx
Published in Declan Costello, Guri Sandhu, Practical Laryngology, 2015
Vocal fold paralysis (VFP) may appear in the wake of a stroke. The close proximity of the nucleus ambiguus to other CN nuclei dictates that VFP is virtually never an isolated finding; almost always, it is found in conjunction with other deficits, a circumstance that adds to its morbidity. Significant dysphagia is found in 30–50% of stroke patients, and aspiration is a leading cause of death.1–3 VFP may follow lacunar or cortical strokes, but is most common after medullary infarcts.4 Wallenberg syndrome (lateral medullary infarct) is a well-known complex of neural injury from posterior inferior cerebellar artery thrombosis that features VFP, dysphagia, vertigo, ataxia, Horner’s syndrome and hemifacial sensory deficit and/or pain. Although many cases of VFP recover or improve over weeks to months, all necessary measures should be taken in the short term to prevent aspiration.
Paralysis of the Larynx
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
A number of neurologic conditions remain relevant, albeit unusual causes of laryngeal paralysis. In contrast to other causes, some of these may be through a central mechanism. Vocal fold paralysis may appear in the wake of a stroke, almost always in conjunction with other deficits. Lateral medullary infarct (Wallenberg syndrome) is a complex of neural injury featuring vocal fold paralysis, dysphagia, vertigo, ataxia, Horner syndrome and hemifacial sensory deficit and/or pain. The vocal fold paralysis tends to improve with time, although measures may be needed in the short term to prevent aspiration. The vocal fold paralysis of Arnold-Chiari malformation tends to be bilateral, and it is important to recognize promptly because it is reversible with timely hindbrain decompression. Charcot–Marie–Tooth disease and its variants are a heterogeneous group of hereditary motor and sensory neuropathies that may involve the laryngeal nerves. Neural compromise of the vocal fold appears to evolve slowly but relentlessly and is usually bilateral. Postpolio syndrome, a degenerative neurologic condition seen many decades after the acute disease, may present as a complex of bulbar deficits resulting in dysphagia, dysphonia and dysarthria. A similar presentation may be seen in multisystem atrophy, a degenerative parkinsonian condition where laryngeal neurologic dysfunction may contribute to mortality by creating respiratory obstruction. Laryngeal weakness may also figure in oculopharyngeal dystrophy and inclusion body myositis, although the mechanisms of nerve involvement are not fully understood in those conditions.
Skew Deviation
Published in Journal of Binocular Vision and Ocular Motility, 2022
Walter and Trobe’s 2021 review of 157 cases in a neuro-ophthalmology practice7 is the largest since the advent of MRI, showing that skew may be an isolated finding with no pertinent neuroimaging abnormality (11%) but is most often accompanied by at least one additional neurologic sign (85%) and frequently two or more (52%). The most frequent signs reported were nystagmus (47%), gaze deficits (17%), ataxia (15%), saccadic pursuit (15%) and internuclear ophthalmoplegia (11%). Infrequent neurologic signs included abduction deficit, dorsal midbrain syndrome, hemiparesis, Horner syndrome, visual field defect, saccadic slowing, saccadic dysmetria, dysarthria, impaired cognition, Wallenberg syndrome, afferent pupil defect and quadriplegia.