Oropharyngeal dysphagia spectrum in Wallenberg syndrome: a case report

Abstract

Swallowing disorders are common clinical data in patients with Wallenberg syndrome, although with a broad clinical spectrum previously described. The objective of the study was to describe the characteristics of the spectrum of oropharyngeal dysphagia presentation in patients with Wallenberg syndrome. We performed a single-center, retrospective study in January 2016 and November 2020 with a series of cases and literature search. Data were collected from eight patients with ischemic spinal injury treated in the Phoniatrics Department of the General Hospital of Mexico. Eight cases were included, aged 28 and 74 years. In the first Fiber-optic Endoscopic Evaluation of Swallowing (FEES), the diagnosis was severe oropharyngeal dysphagia in 7 of the 8 patients (87.5%), compared to the second evaluation where mild oropharyngeal dysphagia was present in four patients, and severe oropharyngeal dysphagia on the other half. Oropharyngeal dysphagia can be found in 51-94% of patients with Wallenberg syndrome. In the first evaluation, difficulty with bolus propulsion of the oral phase in FEES was present in 62.5% of the patients. Still, in the second evaluation, the oral stage was reported with no alterations. Thus, patients could persist with severe dysphagia even passing the month of diagnosis. Wallenberg syndrome is a well-known condition that presents in a very variable way. Dysphagia could be severe, even passing the month after establishing the disease. The evaluation of dysphagia will allow their early rehabilitation and reduce the risk of complications.