Paroxysmal rhinorrhea after medullary infarct

Area of Science:

• Neurology
• Autonomic Nervous System Research
• Stroke Medicine

Background:

• Lateral medullary infarction, commonly known as Wallenberg syndrome, is a type of ischemic stroke.
• Wallenberg syndrome can manifest with various neurological deficits, including autonomic dysfunction.
• Sympathetic nervous system dysfunction is a recognized, though less common, complication of this condition.

Observation:

• A patient presented with a unique symptom of unilateral intermittent rhinorrhea.
• The onset of rhinorrhea coincided with an ischemic stroke affecting the ipsilateral lateral medulla and cerebellum.
• This specific presentation suggests a localized neurological cause for the rhinorrhea.

Findings:

• The unilateral rhinorrhea was hypothesized to be a consequence of sympathetic autonomic system dysfunction.
• The stroke's location in the lateral medulla likely disrupted sympathetic pathways controlling nasal function.
• This case highlights a potential, previously underreported, manifestation of Wallenberg syndrome.

Implications:

• This case expands the known spectrum of symptoms associated with Wallenberg syndrome.
• It suggests that autonomic dysfunction, specifically sympathetic deficits, should be considered in patients with lateral medullary infarction.
• Further research into the neural pathways of autonomic control in the brainstem may elucidate the mechanisms behind such symptoms.