Wallenberg syndrome – Medicine MCQ

Which of the following is not a part of Wallenberg syndrome?
A. Ipsilateral Horner’s syndrome
B. Ipsilateral loss of taste
C. Contralateral impaired thermal sensation over the arm
D. Contralateral atrophy of tongue

Correct answer: D. Contralateral atrophy of tongue

Section of Medulla oblongata

Explanation:
Wallenberg syndrome (Lateral medullary syndrome) can occur due to the occlusion of vertebral artery, posterior inferior cerebellar artery or lateral medullary arteries. It presents with the following features:

Ipsilateral features:
1. Ataxia
2. Loss of pain, impaired sensation over half of face
3. Nausea, vertigo, nystagmus and diplopia
4. Horner’s syndrome
5. Dysphagia, diminished gag reflex, vocal cord palsy
6. Loss of taste
7. Numbness of arm, leg or trunk

Contralateral features:
1. Impaired thermal and pain sensation over half of the body

Ipsilateral paralysis with atrophy of half of tongue and contralateral paralysis of arms and legs sparing face with impaired tactile and proprioceptive sensation occurs in medial medullary syndrome.

Image credits: Henry Gray (1918) Anatomy of the Human Body. https://upload.wikimedia.org/wikipedia/commons/9/94/Gray694.png

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