May be associated with Wallenburg's syndrome and is a rare cause of facial ulcerations associated with injury to the trigeminal nerve (Parimalam 2014) with the syndrome comprised of triad ofģ. involvement of central tegmental tract: palatal myoclonusĪ.involvement of Deiters' nucleus and other vestibular nuclei: nystagmus and vertigo.involvement of hypthalamic fibers: sympathetic nervous system abnormal c/w Horners syndrome The exact cause of pica is not known, but it may be associated with certain medical conditions (gastric parasites, sickle cell disease, iron deficiency).involvement of spinothalamic tract: loss of pain and temperature sensation to the opposite side of body.involvement of trigeminal nucleus: ipsilateral facial and corneal anesthesia The Pica syndrome is an eating disorder characterized by an excessive or abnormal desire to consume a non-nourishing substance which can be relatively.laryngeal, pharyngeal and palatal paralysis.involvement of nucleus ambiguus: dysphagia, dysphonia and dysarthria.Vertebral artery dissection associated with:.Hypertension is most common risk factor with other causes.Most commonly caused by atherothrombotic occlusion of the vertebral artery (then posterior inferior cerebellar arteray and least often the medullary arteries.Estimated 60,000 new cases in the United States each year with usually a better outcome - with most common sequelae being gait instability and most patients returning to satisfactory activities of daily living(Lui 2019). A complete Wallenberg syndrome is not common with key factors in clinical diagnosis being 'crossed hemiparesis or hemianesthesia' indicating a brainstem lesionĥ. may also be associated with obstructive sleep apnea and airway obstruction (Vaidyanathan 2007)Ĥ.Otolaryngological features include dysphonia, dysphagia and nasal regurgitation related to.Clinical symptoms include difficulty swallowing, slurred speech, facial pain, vertigo, Horner syndrome, and possibly palatal myoclonus.It is typified by vertigo, ipsilateral hemiataxia, dysarthria, ptosis and miosis. loss of pain and temperature sensation on the ipsilateral (same) side of the face. The PICAstroke syndrome is also known as 'lateral medullary syndrome', or 'Wallenbergs syndrome', after Wallenbergs description in 1895.Sensory deficits affecting the face and cranial nerves on the same side with the infarct.

loss of pain and temperature sensation on the contralateral (opposite) side of the body.Sensory deficits affecting the trunk (torso) and extremities on the opposite side of the infarction.Constellation of neurologic symptoms due to injury to the lateral part of the medulla in the brain.Wallenberg syndrome = Lateral medullary syndrome (aka 'PICA' syndrome Posterior Inferior Cerebellar Artery syndrome) Return to: Unilateral Laryngeal Paralysis or Vocal Cord Paralysis see: Tapia Syndrome paralysis of vagus and hypoglossal nerves after intubation Wallenberg Syndrome (PICA Syndrome or Lateral Medullary Infaction)

Pica syndrome.