Pain and neuroma formation in Wallenberg's lateral medullary syndrome.
We report a patient with a Wallenberg's lateral medullary syndrome in which pain was a prominent feature. This led to substitution of the original and correct diagnosis by that of a thalamic syndrome for which a prefrontal leucotomy was performed. The patient died some years later from a myocardial infarction and autopsy was performed. In the dorsolateral part of the medulla oblongata a cavity was found in which aberrant nerve fibres with neuroma-like formations could be seen. These fibres coursed along blood vessels, and penetrated from the surface of the medulla oblongata. On the base of the clinico-pathological correlations, it is conjectured that destruction of the lateral reticular formation cannot be the sole cause of the severe pain.
D001932:Brain Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D003951:Diagnostic Errors; D006801:Humans; D002542:Intracranial Embolism and Thrombosis / Q000150:complications*; D014854:Lateral Medullary Syndrome / Q000150:complications* / Q000175:diagnosis; D008297:Male; D008526:Medulla Oblongata; D008875:Middle Aged; D009463:Neuroma / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D010146:Pain; D013786:Thalamic Diseases / Q000175:diagnosis