Wallenberg Syndrome in MS

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Identifier Wallenberg_in_MS
Title Wallenberg Syndrome in MS
Alternative Title Video 6.20 A "central" HINTS exam in a lateral medullary syndrome from Neuro-Ophthalmology and Neuro-Otology Textbook
Creator Daniel R. Gold, DO
Affiliation (DRG) Departments of Neurology, Ophthalmology, Neurosurgery, Otolaryngology - Head & Neck Surgery, Emergency Medicine, and Medicine, The Johns Hopkins School of Medicine, Baltimore, Maryland
Subject Vestibulo-ocular Reflex; Head Impulse Testing; Abnormal Alignment; Lateropulsion; Wallenberg Syndrome; Medulla; Vestibular Nystagmus; Skew Deviation
Description 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: 30-yo-woman with MS presenting with acute vertigo and vertical diplopia. Examination demonstrated several aspects of the Wallenberg syndrome (her acute demyelinating lesion was in the left lateral medulla): ipsilesional (left) ocular lateropulsion (hypermetric saccades to the left, hypo to the right, not seen in the video), ipsilesional (left) hypotropia from skew deviation, and subtle right-beating nystagmus (not seen in the video). There was also a + head impulse test, which is typically a "peripheral" sign, although her + result was due to left vestibular nucleus involvement. A negative HIT is highly suggestive of a central localization in the acute vestibular syndrome whereas a + HIT can result from either peripheral or central localizations. 𝗡𝗲𝘂𝗿𝗼-𝗼𝗽𝗵𝘁𝗵𝗮𝗹𝗺𝗼𝗹𝗼𝗴𝘆 𝗮𝗻𝗱 𝗡𝗲𝘂𝗿𝗼-𝗼𝘁𝗼𝗹𝗼𝗴𝘆 𝗧𝗲𝘅𝘁𝗯𝗼𝗼𝗸 𝗟𝗲𝗴𝗲𝗻𝗱: This patient presented with the acute vestibular syndrome in addition to vertical diplopia. Examination demonstrated several aspects of the left lateral medullary (Wallenberg) syndrome to an acute demyelinating lesion: ipsilesional (left) ocular lateropulsion (ipsipulsion, as well as hypermetric saccades to the left, hypo to the right, not seen in the video), ipsilesional (left) hypotropia from skew deviation, and subtle right-beating nystagmus (not seen in the video). There was also an abnormal head impulse test, which although typically seen as a "peripheral" sign, can be central in origin as in this case (due to left vestibular nucleus involvement) https://collections.lib.utah.edu/details?id=187730
Date 2016
Language eng
Format video/mp4
Type Image/MovingImage
Collection Neuro-Ophthalmology Virtual Education Library: Dan Gold Neuro-Ophthalmology Collection: https://novel.utah.edu/Gold/
Publisher North American Neuro-Ophthalmology Society
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah, 10 N 1900 E SLC, UT 84112-5890
Rights Management Copyright 2016. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright
ARK ark:/87278/s6ck1p47
Setname ehsl_novel_gold
ID 187730
Reference URL https://collections.lib.utah.edu/ark:/87278/s6ck1p47
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