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Lateral medullary syndrome

MedGen UID:
53057
•Concept ID:
C0043019
•
Disease or Syndrome
Synonyms: PICA syndrome; Posterior inferior cerebellar artery syndrome; Vertebral artery syndrome; Wallenberg syndrome; Wallenberg's syndrome
SNOMED CT: LMS - Lateral medullary syndrome (78569004); Posterior inferior cerebellar artery syndrome (78569004); Wallenberg's syndrome (78569004); Lateral medullary syndrome (78569004); Inferior cerebellar artery syndrome (78569004)
 
Monarch Initiative: MONDO:0006827

Definition

A syndrome caused by an infarct in the vertebral or posterior inferior cerebellar artery. It is characterized by sensory defects affecting the same side of the face as the infarct and the opposite side of the trunk as the infarct. Patients experience difficulty swallowing and/or speaking. [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVLateral medullary syndrome

Professional guidelines

PubMed

Multimodal treatment of ruptured dissecting aneurysms of the vertebral artery during the acute stage.
Hamada J, Kai Y, Morioka M, Yano S, Todaka T, Ushio Y
J Neurosurg 2003 Dec;99(6):960-6. doi: 10.3171/jns.2003.99.6.0960. PMID: 14705721
Diagnosis and treatment of vertebral aneurysms.
Yamaura A
J Neurosurg 1988 Sep;69(3):345-9. doi: 10.3171/jns.1988.69.3.0345. PMID: 3404230

Recent clinical studies

Etiology

Vascular vertigo and dizziness: Diagnostic criteria.
Kim JS, Newman-Toker DE, Kerber KA, Jahn K, Bertholon P, Waterston J, Lee H, Bisdorff A, Strupp M
J Vestib Res 2022;32(3):205-222. doi: 10.3233/VES-210169. PMID: 35367974Free PMC Article
Characteristics and Prognostic Factors of Swallowing Dysfunction in Patients with Lateral Medullary Infarction.
Hara N, Nakamori M, Ayukawa T, Matsushima H, Hayashi Y, Imamura E, Mizoue T, Wakabayashi S
J Stroke Cerebrovasc Dis 2021 Dec;30(12):106122. Epub 2021 Sep 25 doi: 10.1016/j.jstrokecerebrovasdis.2021.106122. PMID: 34583216
Clinical and Radiological Characteristics Associated with Respiratory Failure in Unilateral Lateral Medullary Infarction.
Pavšič K, Fabjan A, Zgonc V, Šurlan Popović K, Pretnar Oblak J, Bajrović FF
J Stroke Cerebrovasc Dis 2021 Sep;30(9):105947. Epub 2021 Jun 27 doi: 10.1016/j.jstrokecerebrovasdis.2021.105947. PMID: 34192618
Lateral Medullary Syndrome Following Injury of Lateral Vestibulospinal Tract: Diffusion Tensor Imaging Study.
Jang SH, Oh S, Yeo SS
J Stroke Cerebrovasc Dis 2020 Nov;29(11):105252. Epub 2020 Aug 28 doi: 10.1016/j.jstrokecerebrovasdis.2020.105252. PMID: 33066903
Lateral Medullary Infarction with or without Extra-Lateral Medullary Lesions: What Is the Difference?
Kang HG, Kim BJ, Lee SH, Kang DW, Kwon SU, Kim JS
Cerebrovasc Dis 2018;45(3-4):132-140. Epub 2018 Mar 20 doi: 10.1159/000487672. PMID: 29558752

Diagnosis

Vascular vertigo and dizziness: Diagnostic criteria.
Kim JS, Newman-Toker DE, Kerber KA, Jahn K, Bertholon P, Waterston J, Lee H, Bisdorff A, Strupp M
J Vestib Res 2022;32(3):205-222. doi: 10.3233/VES-210169. PMID: 35367974Free PMC Article
Lateral Medullary Syndrome Following Injury of Lateral Vestibulospinal Tract: Diffusion Tensor Imaging Study.
Jang SH, Oh S, Yeo SS
J Stroke Cerebrovasc Dis 2020 Nov;29(11):105252. Epub 2020 Aug 28 doi: 10.1016/j.jstrokecerebrovasdis.2020.105252. PMID: 33066903
Neuroanatomical basis of Wallenberg syndrome.
Gasca-González OO, Pérez-Cruz JC, Baldoncini M, Macías-Duvignau MA, Delgado-Reyes L
Cir Cir 2020;88(3):376-382. doi: 10.24875/CIRU.19000801. PMID: 32539005
Lateral Medullary Infarction with or without Extra-Lateral Medullary Lesions: What Is the Difference?
Kang HG, Kim BJ, Lee SH, Kang DW, Kwon SU, Kim JS
Cerebrovasc Dis 2018;45(3-4):132-140. Epub 2018 Mar 20 doi: 10.1159/000487672. PMID: 29558752
Vertebrobasilar ischemia.
Becker KJ
New Horiz 1997 Nov;5(4):305-15. PMID: 9433983

Therapy

Reversible drug-induced antiphospholipid syndrome.
Risse J, Vieira M, Beuret F, Petitpain N, Zuily S, Wahl D
Lupus 2018 Feb;27(2):333-335. Epub 2017 Jun 7 doi: 10.1177/0961203317712463. PMID: 28592198
Syndrome of inappropriate secretion of antidiuretic hormone (SIADH) associated with lateral medullary syndrome: case report and literature review.
Nakano H, Yanase D, Yamada M
BMC Neurol 2016 Jul 27;16:119. doi: 10.1186/s12883-016-0641-0. PMID: 27461339Free PMC Article
Anti phospholipid syndrome.
Miah MT, Hoque MA, Sutradhar SR, Mahmood T, Tarafder BK
Mymensingh Med J 2009 Jan;18(1):72-4. PMID: 19182754
Head-shaking nystagmus in lateral medullary infarction: patterns and possible mechanisms.
Choi KD, Oh SY, Park SH, Kim JH, Koo JW, Kim JS
Neurology 2007 Apr 24;68(17):1337-44. doi: 10.1212/01.wnl.0000260224.60943.c2. PMID: 17452577
Vertebrobasilar ischemia.
Becker KJ
New Horiz 1997 Nov;5(4):305-15. PMID: 9433983

Prognosis

Case report: Lateral medullary syndrome with eight-and-a-half syndromes.
Zuo C, Zhao M, Zhao L, Meng N, Xing X, Li N
Medicine (Baltimore) 2024 Feb 9;103(6):e34409. doi: 10.1097/MD.0000000000034409. PMID: 38335410Free PMC Article
Dysphagia in Lateral Medullary Syndrome: A Narrative Review.
Jang SH, Kim MS
Dysphagia 2021 Jun;36(3):329-338. Epub 2020 Jul 11 doi: 10.1007/s00455-020-10158-3. PMID: 32654058
Lateral Medullary Syndrome Following Injury of Lateral Vestibulospinal Tract: Diffusion Tensor Imaging Study.
Jang SH, Oh S, Yeo SS
J Stroke Cerebrovasc Dis 2020 Nov;29(11):105252. Epub 2020 Aug 28 doi: 10.1016/j.jstrokecerebrovasdis.2020.105252. PMID: 33066903
Lateral Medullary Infarction with or without Extra-Lateral Medullary Lesions: What Is the Difference?
Kang HG, Kim BJ, Lee SH, Kang DW, Kwon SU, Kim JS
Cerebrovasc Dis 2018;45(3-4):132-140. Epub 2018 Mar 20 doi: 10.1159/000487672. PMID: 29558752
Lateral medullary syndrome: a diagnostic approach illustrated through case presentation and literature review.
Day GS, Swartz RH, Chenkin J, Shamji AI, Frost DW
CJEM 2014 Mar;16(2):164-70. doi: 10.2310/8000.2013.131059. PMID: 24626124

Clinical prediction guides

Characteristics and Prognostic Factors of Swallowing Dysfunction in Patients with Lateral Medullary Infarction.
Hara N, Nakamori M, Ayukawa T, Matsushima H, Hayashi Y, Imamura E, Mizoue T, Wakabayashi S
J Stroke Cerebrovasc Dis 2021 Dec;30(12):106122. Epub 2021 Sep 25 doi: 10.1016/j.jstrokecerebrovasdis.2021.106122. PMID: 34583216
Clinical and Radiological Characteristics Associated with Respiratory Failure in Unilateral Lateral Medullary Infarction.
Pavšič K, Fabjan A, Zgonc V, Šurlan Popović K, Pretnar Oblak J, Bajrović FF
J Stroke Cerebrovasc Dis 2021 Sep;30(9):105947. Epub 2021 Jun 27 doi: 10.1016/j.jstrokecerebrovasdis.2021.105947. PMID: 34192618
Lateral Medullary Syndrome Following Injury of Lateral Vestibulospinal Tract: Diffusion Tensor Imaging Study.
Jang SH, Oh S, Yeo SS
J Stroke Cerebrovasc Dis 2020 Nov;29(11):105252. Epub 2020 Aug 28 doi: 10.1016/j.jstrokecerebrovasdis.2020.105252. PMID: 33066903
Lateral Medullary Infarction with or without Extra-Lateral Medullary Lesions: What Is the Difference?
Kang HG, Kim BJ, Lee SH, Kang DW, Kwon SU, Kim JS
Cerebrovasc Dis 2018;45(3-4):132-140. Epub 2018 Mar 20 doi: 10.1159/000487672. PMID: 29558752
Crossed cheiro-oral syndrome: A warning sign for medullary involvement and neurological deterioration.
Chen WH, Yang TP, Yin HL
J Clin Neurosci 2017 May;39:130-132. Epub 2017 Jan 12 doi: 10.1016/j.jocn.2016.12.033. PMID: 28089423

Recent systematic reviews

Opalski syndrome: A comprehensive systematic review of cases.
Rezaei Zadeh Rukerd M, Mirkamali H, Alizadeh SD
Clin Neurol Neurosurg 2024 Oct;245:108474. Epub 2024 Jul 31 doi: 10.1016/j.clineuro.2024.108474. PMID: 39096581
The association between contraversive lateropulsion and outcomes post stroke: A systematic review.
Nolan J, Godecke E, Singer B
Top Stroke Rehabil 2022 Mar;29(2):92-102. Epub 2021 Mar 1 doi: 10.1080/10749357.2021.1886640. PMID: 33648434

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