Wallenberg's Syndrome With Proximal Quadriparesis

Background: There are several variants of Wallenberg's syndrome. Wallenberg's syndrome with proximal quadriparesis has not been reported before. Case Summary: We report a 25-year-old woman presenting with sudden onset of vertigo, hoarseness, dysphagia, right facial numbness, and proximal quadriparesis. Brain magnetic resonance imaging revealed right posterolateral medullary infarction with medial extension and sparing of the pyramidal tracts. The proximal quadriparesis improved substantially 2 weeks after stroke onset. Conclusion: The proximal quadriparesis can be explained by involvement of the right medial medullary reticular formation. Our observation supports the hypothesis that the proximal part of the limb is bilaterally innervated by axons of the corticoreticulospinal tracts in human beings. The rapid recovery of proximal quadriparesis also supports the concept that a functional pyramidal tract seems crucial for recovery after stroke.