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Lateral Medullary Vs Lateral Pontine
In both the lateral meduallary syndrome (Wallenburg syndrome) and in the lateral pontine syndrome we have these lesions:
So how to tell the difference between the two?
- Ipsilateral horner because of lesioned descending hypothalamics
- Contralateral loss of pain and temperature due to the spinothalamic tract cut
- Ipsilateral cerebellar ataxia because of a lesion in the cerebellar peduncles (inferior in the case of the medulla and middle in the case of pons)
- Vertigo, vomiting, and nystagmus due to vestibular nuclei involvement
- Ipsilateral loss of pain and temperature in the half of the face due to spinal V nucleus lesion
- Ipsilateral hearing loss due to cochlear nucleus involvement
- Nucleus ambiguous and nucleus solitarius with resultant loss of gag, taste, dysphagia, swallowing, etc is seen only in Wallenburg
- Motor involvement of the Trigeminal is seen only in lateral pontine (specially if it is a rostral lesion) with ipsilateral loss of touch and mastication on the side of the face
- Facial involvement is sometimes seen in lateral pontine but not in lateral medullary syndrome with it's loss of anterior 2/3 taste, lacrimation, facial expression, corneal reflex, and hyperacusis
Last edited by rasheed; 09-18-2009 at 03:27 PM.