Wallenberg’s Syndrome Essay

Wallenberg syndrome is a “rare disease” just because it is not commonly reported. Nevertheless, the disease is real and requires attention like any other more common disease. This syndrome affects the posterior inferior cerebellar artery and/or vertebral artery (Kimura & Lyon, 1972). Once these parts of the brain are affected, a patient may have difficulties in swallowing anything and may also tamper with their voice and therefore have problems with their speech. The present paper will scrutinize the effects of Wallenberg syndrome upon speech of a patient.Wallenberg’s Syndrome Essay

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To start with, it is vital to look on how the body functions because of the syndrome. Basically, the human body involves sensory communication for passing instructions to various body parts. Some of these instructions are responsible for speech and language control and will therefore manage the language and speech of an individual.

As seen above, the Wallenberg Syndrome affects the posterior cerebellar artery and vertebral artery which are connected to the spinal cord (SCHWARZ, GEIGER, & SPANO, 1956). The spinal cord requires messages from the brain to perform the motor and sensory functions to be able to send a message to the vocal band which is responsible for voice, speech and language. Therefore, for proper functioning of the sensory and motor neurons this message has to be successfully delivered to the spinal cord from the brain.

The disease in question affects the communication channel between the spinal cord and the brain. Therefore, the proper message which is responsible for controlling the voice and language of an individual will not be delivered to the spinal cord to facilitate the functioning of the motor neurons. The motor neuron is responsible for muscle control and even a slight interference with it means that the muscles and all activities controlled by the muscles malfunction.Wallenberg’s Syndrome Essay

According to Kimura and Lyon (1972), what happens is that the message from the nerve cells in the brain needs to be transmitted to the spinal cord, and then from the spinal cord to various muscles through the motor neurons, and some of these muscles are the ones responsible for language coordination. As seen in the discussion, the Wallenberg Syndrome affects the pathway between the brain and the spinal cord, therefore bearing the message from the brain to the spinal cord or altering it. This will therefore result to the neurons not delivering the correct message to the muscles which deal with speech and language. Once this happens, muscular activities are affected.Wallenberg’s Syndrome Essay

In a more specific way, we have the upper motor neurons and lower motor neurons and both control various muscles. The vocal muscles (responsible for language and speech) and mouth muscles are controlled by the upper motor neurons. Therefore, if the message altered from the beginning is the one that is connected to the upper motor neurons, an individual will have difficulties in chewing and speaking since the muscles responsible for these activities are the ones affected (Dhamoon et al., 1984). Therefore, the speech of an individual is affected with the same degree as the upper motor neurons are.Wallenberg’s Syndrome Essay

In summary, Wallenberg is not a common syndrome, but it is real. This syndrome affects the posterior inferior cerebellar artery and/or vertebral artery which are the communication pathways between the brain and the spinal cord. Therefore, the message communicated by the nerve cells of the brain fails to reach the spinal cord. The spinal cord receives the message from the brain and communicates accordingly to the various parts of the body using the motor neurons. Since the message is barred, the communication to the upper motor neuron which is responsible for speech and mouth muscular control is affected. Therefore, the patient’s speech is affected to the same degree as the communication between the brain nerve cells and the spinal cord is.

Wallenberg syndrome = Lateral medullary syndrome (aka ‘PICA’ syndrome Posterior Inferior Cerebellar Artery syndrome)

Constellation of neurologic symptoms due to injury to the lateral part of the medulla in the brain
Sensory deficits affecting the trunk (torso) and extremities on the opposite side of the infarction
loss of pain and temperature sensation on the contralateral (opposite) side of the body
Sensory deficits affecting the face and cranial nerves on the same side with the infarct.Wallenberg’s Syndrome Essay
loss of pain and temperature sensation on the ipsilateral (same) side of the face.
Clinical symptoms include difficulty swallowing, slurred speech, facial pain, vertigo, Horner syndrome, and possibly palatal myoclonus
​Otolaryngological features include dysphonia, dysphagia and nasal regurgitation related to
​ipsilateral vocal fold paralysis
palatal and pharyngeal paresis
may also be associated with obstructive sleep apnea and airway obstruction (Vaidyanathan 2007)
4. A complete Wallenberg syndrome is not common with key factors in clinical diagnosis being ‘crossed hemiparesis or hemianesthesia’ indicating a brainstem lesion

5. Estimated 60,000 new cases in the United States each year with usually a better outcome – with most common sequelae being gait instability and most patients returning to satisfactory activities of daily living(Lui 2019).Wallenberg’s Syndrome Essay

Etiology:

Most commonly caused by atherothrombotic occlusion of the vertebral artery (then posterior inferior cerebellar arteray and least often the medullary arteries.
Risk factors
Hypertension is most common risk factor with other causes
Vertebral artery dissection associated with:
History of trauma, neck
Underlying collagen vascular disease

Some people with Wallenberg’s syndrome have difficulty balancing while walking because they feel like the world is tilting.

Wallenberg’s syndrome, also called lateral medullary syndrome or Wallenberg syndrome, is a neurological condition that can develop when damage occurs in a part of the brainstem called the lateral medulla.Wallenberg’s Syndrome Essay

When one of the arteries of the brainstem is blocked, oxygenated blood can’t get to the brain, and a stroke can occur.

If this happens, you may experience problems with muscle function and sensations throughout your body.

Wallenberg’s syndrome is considered a rare disorder, affecting fewer than 200,000 people in the United States.

Symptoms of Wallenberg’s Syndrome
The most common symptom people with Wallenberg’s syndrome have is difficulty swallowing.

Other symptoms may include the following:Wallenberg’s Syndrome Essay

Hoarseness
Dizziness, nausea, and vomiting
Rapid involuntary eye movements
Difficulty with balance and gait coordination
Problems with body temperature sensation
Lack of pain and temperature sensation on one side of the face, or different symptoms on each side of the body
Uncontrollable hiccups
Loss of taste on one side of the tongue
Decreased sweating
Changes in heart rate and blood pressure
Additionally, some people with Wallenberg’s syndrome have difficulty balancing while walking because they feel like the world is tilting.

Depending on how severe the damage to the brainstem is, some people may feel relief from symptoms within weeks or months.

Others, however, may experience major neurological disabilities for years.Wallenberg’s Syndrome Essay

Causes of Wallenberg’s Syndrome
It’s not known what initially causes Wallenberg’s syndrome.

However, some researchers have found a connection between people who have the syndrome and who have peripheral artery disease, heart disease, blood clots, or minor neck trauma.

Diagnosis of Wallenberg’s Syndrome
If your doctor thinks you may have Wallenberg’s syndrome, he or she may order a computed tomography (CT) scan or magnetic resonance imaging (MRI) to identify if there is a block in the artery near the lateral medulla.

Treatment of Wallenberg’s Syndrome
Since there is no cure for Wallenberg’s syndrome, treatment usually involves relieving the symptoms a person is experiencing, which may include the following:

A feeding tube to help with swallowing complications
Speech and/or swallowing therapy to help with talking and swallowing
Medication to help alleviate pain, such as the anti-epileptic drug gabapentin (Neurontin)
Blood thinner medication, such as heparin or warfarin (Coumadin), to help reduce or dissolve the blockage in the artery
Rarely, and only in extreme cases, surgery may be an option to remove the clot Wallenberg’s Syndrome Essay