title: Unilateral punctate keratitis secondary to Wallenberg Syndrome.
abstract: We studied three patients who developed left unilateral punctate keratitis after suffering left-sided Wallenberg Syndrome. A complex evolution occurred in two of them. In all cases, neurophysiological studies showed damage in the trigeminal sensory component at the bulbar level. Corneal involvement secondary to Wallenberg syndrome is a rare cause of unilateral superficial punctate keratitis. The loss of corneal sensitivity caused by trigeminal neuropathy leads to epithelial erosions that are frequently unobserved by the patient, resulting in a high risk of corneal-ulcer development with the possibility of superinfection. Neurophysiological studies can help to locate the anatomical level of damage at the ophthalmic branch of the trigeminal nerve, confirming the suspected etiology of stroke, and demonstrating that prior vascular involvement coincides with the location of trigeminal nerve damage. In some of these patients, oculofacial pain is a distinctive feature.
authors.affiliation: Ophthalmology Service, Hospital La Paz, Madrid, Spain.
authors.forename: Pino
authors.initials: P
authors.lastname: Cidad
authors.affiliation: Ophthalmology Service, Hospital La Paz, Madrid, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Boto
authors.affiliation: Ophthalmology Service, Hospital La Paz, Madrid, Spain.
authors.forename: Almudena
authors.initials: A
authors.lastname: Del Hierro
authors.affiliation: Ophthalmology Service, Hospital La Paz, Madrid, Spain.
authors.forename: Maria
authors.initials: M
authors.lastname: Capote
authors.affiliation: Ophthalmology Service, Hospital La Paz, Madrid, Spain.
authors.forename: Susana
authors.initials: S
authors.lastname: Noval
authors.affiliation: Ophthalmology Service, Hospital La Paz, Madrid, Spain.
authors.forename: Amanda
authors.initials: A
authors.lastname: Garcia
authors.affiliation: Neurophysiology Service, Hospital La Paz, Madrid, Spain.
authors.forename: Susana
authors.initials: S
authors.lastname: Santiago
mesh_terms: D000368:Aged; D003315:Cornea / Q000473:pathology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007634:Keratitis / Q000175:diagnosis / Q000209:etiology*; D014854:Lateral Medullary Syndrome / Q000150:complications*; D008875:Middle Aged
keywords: Corneal sensitivity; Lateral medullary syndrome; Neurotrophic ulcer; Punctate keratitis; Trigeminal nerve