Wallenberg Syndrome And Isolated Lateral Bulbar Infarction: Clinical Characteristics And Prognosis In A Cohort Of Mexican Patients

Background: Wallenberg syndrome (WS) is a classic neurologic disorder secondary to vascular pathology of the vertebrobasilar circulation. Methods: Consecutive patients > 18 years with WS and isolated lateral medullary infarction syndrome were included from two Mexican hospitals. Risk factors, initial signs, symptoms, radiological findings, and acute treatment were evaluated; the prognosis was assessed using the Glasgow Outcome Scale. Results: Twenty-six patients were studied in a 26- year period (1988-2014); 17 patients were men (67%); and the average age was 45 years (range 19-77). Fourteen patients were under 45 years old (54%). The most common risk factors were dyslipidemia (41%) and hypertension (37%). The main initial symptoms were vertigo-dizziness (89%) gait ataxia (70%), and crossed-sensory deficit; and the main signs were crossed-sensitive deficit (93%), Horner syndrome (85%), and nystagmus (82%). In the bivariate analysis, age under 45 years was associated with a vertebral arterial dissection (p = 0.001), and age > 45 with atherothrombotic etiology (p = 0.01). About 96% of patients presented good recovery at an average of 17 months follow-up. Conclusion: Non-atherosclerotic vasculopathy was the main cause of WS-ILBI in young people. The clinical characteristics were similar to those reported in other series with a usually benign prognosis.