Wallenberg's Syndrome is usually characterized by crossed loss of pain and temperature sense, but there are many clinical variants that indicate different extensions of the lesion. We carried out a retrospective study in 36 patients with Wallenberg's Syndrome or with Avellis's Syndrome; two patterns of sensory defect wewre isolated: each pattern included four groups. Only 52.7% of the patients showed the classic pattern of sensory defect, while47.2% had variants of different importance and meaning. In most of our cases the sensory defect, involving one side of the face and the controlateral side of the body, was correlable to a lesion in the lateral medullary region. In four patients, without sensory loss in the face, a more ventral infarction appeared presumible; on the other hand a selective sensory loss in omolateral side of the face (two cases) seemed to indicate a more dorsolateral lesion. Seven patients had a sensory defect involving only the controlateral leg and trunk, probabably following a far lateral medullary lesion,. Conversely, three patients developed a sensory defect in the controlateral arm and trunk that was correlable with a lesion in the medial portion of spinithalamic tract. Four cases, with sensory impairment of the bilateral side of the face, suggested an involvement of lateral pontine region. Our data confirm that an accurate sensory examination provides subtle details for evaluation of the lesion's level and extension, which even sophisticaded diagnstic tools do not always allow
Topografia delle alterazioni della sensibilità nella Sindrome di Wallemberg
BONANNI, ENRICA
1991-01-01
Abstract
Wallenberg's Syndrome is usually characterized by crossed loss of pain and temperature sense, but there are many clinical variants that indicate different extensions of the lesion. We carried out a retrospective study in 36 patients with Wallenberg's Syndrome or with Avellis's Syndrome; two patterns of sensory defect wewre isolated: each pattern included four groups. Only 52.7% of the patients showed the classic pattern of sensory defect, while47.2% had variants of different importance and meaning. In most of our cases the sensory defect, involving one side of the face and the controlateral side of the body, was correlable to a lesion in the lateral medullary region. In four patients, without sensory loss in the face, a more ventral infarction appeared presumible; on the other hand a selective sensory loss in omolateral side of the face (two cases) seemed to indicate a more dorsolateral lesion. Seven patients had a sensory defect involving only the controlateral leg and trunk, probabably following a far lateral medullary lesion,. Conversely, three patients developed a sensory defect in the controlateral arm and trunk that was correlable with a lesion in the medial portion of spinithalamic tract. Four cases, with sensory impairment of the bilateral side of the face, suggested an involvement of lateral pontine region. Our data confirm that an accurate sensory examination provides subtle details for evaluation of the lesion's level and extension, which even sophisticaded diagnstic tools do not always allowI documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
