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October 21, 1974

Diphenylhydantoin in the Wallenberg Syndrome

Author Affiliations

Albuquerque, NM

JAMA. 1974;230(3):372-373. doi:10.1001/jama.1974.03240030014006

To the Editor.—  The Wallenberg or posterior inferior cerebellar artery syndrome is the most common of the recognized brain stem "stroke" syndromes. Typical sequelae to cerebral thrombosis in the lateral medullary region of the brainstem are dysphagia, dysarthria, dysphonia, ipsilateral facial pain and hypalgesia, contralateral extremity hypalgesia, and ipsilateral incoordination. Surprisingly though, the prognosis for short-term recovery of the major symptoms is relatively good.1 However, in the series of Currier et al2 in which 39 patients with this syndrome were followed up, ipsilateral facial pain was found to be a persistent and disabling symptom in nine of them.We saw a 40-year-old man at the Veterans Administration Hospital who had developed this syndrome two years previously and had been afflicted with ipsilateral burning facial pain around the eye. Ordinary analgesics did not relieve this pain, and he came to the hospital to seek relief. Because of the value