Question

Patient with loss of pain/temp over ipsilateral face/contralateral body, bulbar muscles (dysarthria/dysphagia), vertigo, nystagmus, and Horner's syndrome:

a) Wallenberg syndrome (Lateral medullary syndrome)
b) Bell's palsy
c) Trigeminal neuralgia
d) Ramsay Hunt syndrome

Answer 1

The patient's symptoms indicate Wallenberg syndrome (Lateral medullary syndrome), which is related to damage in the lateral medulla oblongata and can involve symptoms like Horner's syndrome due to the affected descending sympathetic tract.

Step-by-step explanation:

The patient with symptoms of loss of pain/temperature over the ipsilateral face and contralateral body, along with bulbar muscle impairment (manifested as dysarthria and dysphagia), vertigo, nystagmus, and Horner's syndrome, is most likely experiencing Wallenberg syndrome (Lateral medullary syndrome). This condition is caused by a stroke in the lateral part of the medulla oblongata, affecting the structures in this area and potentially impacting the descending sympathetic tract, which explains the presence of Horner's syndrome. Wallenberg syndrome can lead to a variety of sensory and motor deficits including altered sensation over the face due to involvement of the trigeminal nerve fibers and contralateral loss of pain and temperature sensation in the body due to damage to the spinothalamic tract.