Ocular contrapulsion followed by ipsipulsion in Wallenberg syndrome: The first case report in literature.

Autor:	Junior EM; Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil., Magri F; Universidade de São Paulo, São Paulo, SP, Brazil., Silva ABRL; Faculdade de Medicina, Centro Universitário Christus, Fortaleza, CE, Brazil., Diógenes GP; Faculdade de Medicina, Centro Universitário Christus, Fortaleza, CE, Brazil., Aguiar MFC; Faculdade de Medicina, Centro Universitário Christus, Fortaleza, CE, Brazil., Bessa L; Medical Student, FIPMoc University Center, Montes Claros, Brazil., Filho LBA; Faculdade de Medicina, Centro Universitário Christus, Fortaleza, CE, Brazil., de Medeiros SDP; Centro Universitário Facisa - UNIFACISA, Campina Grande, PB, Brazil., da Silva LA; Neuroftalmologia, Chistian Business School, Orlando, Estados Unidos., Antoniol T; Centro Universitário Governador Ozanam Coelho, Ubá, MG, Brazil., Oliveira LF; Universidade Federal de São Paulo, São Paulo, SP, Brazil.; Laboratório de Neurociências, Departamento de Neurologia e Neurocirurgia, Universidade Federal de São Paulo, São Paulo, SP, Brazil.; Neuroftalmologia, Chistian Business School, Orlando, Estados Unidos., Claudino Dos Santos JC; Universidade Federal de São Paulo, São Paulo, SP, Brazil.; Laboratório de Neurociências, Departamento de Neurologia e Neurocirurgia, Universidade Federal de São Paulo, São Paulo, SP, Brazil.; Neuroftalmologia, Chistian Business School, Orlando, Estados Unidos.
Jazyk:	angličtina
Zdroj:	Radiology case reports [Radiol Case Rep] 2022 Sep 06; Vol. 17 (11), pp. 4148-4151. Date of Electronic Publication: 2022 Sep 06 (Print Publication: 2022).
DOI:	10.1016/j.radcr.2022.06.099
Abstrakt:	Wallenberg syndrome is also called lateral medullary syndrome, a neurological disorder resulting from occlusion of the vertebral artery or the posterior inferior cerebellar artery. The clinical presentations are associated with a variety of indications, including vestibulocerebellar symptoms, autonomic dysfunction and ipsilateral cerebellar signs. The ipsipulsion, an abnormality of the ocular movement associated with the Wallenberg syndrome, is more specific to the lateral medullary syndrome and is characterized by a tonic deviation of the eyes in the direction of the damaged side, more prominently when the visual fixation is interrupted. A 51-year-old male patient presented with a sudden permanent rotatory dizziness, unsteady gait, numbness in the left hemibody, left palate paresis, incoordination on left side and horizontal jerk nystagmus with left fast fase. Magnetic resonance imaging showed infarction in the left medulla and cerebellar. The ocular exam revealed saccadic lateropulsion ipsilateral to lesion. In the neurologic evaluation of the patient with Wallenberg syndrome, numerous abnormalities manifestations are present, such as vestibulo-ocular reflex deficiency, saccadic abnormalities, low pursuance movements and gaze fixation, and eye alignment dysfunction. This semiologic feature had not been described in literature until now. We hypothesize that an initial vasogenic edema extending to the left medial medulla following the acute stroke could explain the early presentation with saccadic counterpulsion. After one week and regression of the edema, the finding of lateropulsion has alternated to the classic ipsipulsion related to Wallenberg syndrome. The following case report depicts a rare case of Wallenberg syndrome associated with alterations of the ocular motricity. (© 2022 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)
Databáze:	MEDLINE
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