[Wallenberg's syndrome: an assessment of the dysphagic and postural symptomatology]

Dysphagia and postural disorders are the most important symptoms of the Wallenberg [correction of Wallemberg] syndrome, which takes in a considerable number of neurological symptoms including an alternate sensitive syndrome, the Claude Bernard Horner syndrome, paralysis of the half palate, of the half pharynx and of the vocal fold on the side of the injury, a vestibular syndrome and, finally, a cerebellar hemisyndrome. In the course of this study, four patients with the Wallenberg [correction of Wallemberg] syndrome were examined and underwent further periodical checks after injury. All the patients were fed employing a naso-gastric tube and in one case an emergency tracheostomy was performed because acute dyspnea. The diagnostic protocol following included the collection of a series of anamnestic data, an objective study of U.A.D.T. with fiberoptic endoscopy, swallowing simulation, dynamic radiologic examination (videofluoroscopy) and computerized static posturography. This routine was repeated upon every successive check. During the first observation a substantial uniformity of physiopathological characteristics was found in all the patients. Following logopedic and rehabilitation treatment, a high degree of diversity in the results obtained was observed in three patients (one of the patients was absent from successive checks). The most interesting phenomenon was the difference in time necessary to rehabilitate the swallowing reflex only after which it was possible to reassume oral alimentation. After two months of physiokinesitherapy, computerized static posturography, which initially revealed a sharp increase in the number of oscillations, showed a partial improvement of the postural disease with a reduction in oscillation amplitude. Even though the number of case followed was limited, our experience encourages us to underline importance of immediate rehabilitation therapy and of the collaboration of patients and their family members.