Treatment of Wallenberg's Syndrome Following Selective Nerve Root Block: A Case Report

요추부 선택적 신경근 차단술 이후 발생한 Wallenberg's Syndrome의 한방복합치료 1례

  • Received : 2016.09.19
  • Accepted : 2016.10.05
  • Published : 2016.10.31


The occurrence of brain stem stroke after lumbar selective nerve root block seem to be an uncommon event comparing it to after cervical selective nerve root block. We recently experienced a 60-year-old man who were diagnosed as left lateral medullary infarction (Wallenberg's syndrome) after lumbar selective nerve root block. He was treated by traditional Korean medicine with acupunture, Pulsed electromagetic therapy (PEMT), herb medicine. The range of motion of upper and lower extremity, manual muscle test, Korean version of Berg balance scale (K-BBS) and Korean version of Barthel index (K-MBI) were adopted to measure the resulting recovery after 4 weeks treatment. Traditional Korean medicine was effective for rehabilitation of patient. Further studies are needed to set up and Korean medical protocol for Wallenberg's syndrome.


Wallenberg's syndrome;Lumbar selective nerve root block;Acupunture;Pulsed electromagnetic therapy;Sokmeyung-tang


  1. Kim, J.S. Pure lateral medullary infarction: Clinical-radiological correlation of 130 acute, consecutive patients. Brain. 2003;126;1864-72.
  2. S. Suresh, J. Berman, David A. Connell. Cerebellar and brainstem infarction as a complication of CT-guided transforaminal cervical nerve root block. Skeletal Radiol. 2007;26:449-52.
  3. Byun SM, Kim MB, Tark MR, Yoon HJ, Ko WS. Clinical Study of One Patient with Wallenberg's syndrome. The Journal of Korean Oriental Medical Ophthalmology & Otolaryngology & Dermatology. 2009;22(2):261-8.
  4. Ryu HC, Kim IG, Seo CH, Choi CW, Lee YS, Kim JS, Kim HC. Three Clinical Reports of Medullary infarction. Korean J. Orient.Int.Med. 2005;26(1):252-64.
  5. Seo SH, Kim SH, Hong SH, Youn HM. Clinical Observationon 1 Case of The Wallenberg's syndrome Caused by The Pons Infarction. The Journal of Korean Acupuncture & Moxibusion Society. 2003;20(5):244-51.
  6. Byun SM, Kim MB, Tark MR, Yoon HJ, Ko WS. Clinical Study of One Patient with Wallenberg's Syndrome. The Journal of Korean Oriental Medical Ophthalmology & Otolaryngology & Dermatology. 2009;22(2):261-8.
  7. Lee SE, Kim YJ, Yun JM, Park SW, Lee MG, Lee SH. Clinical Report of One Patient with the Wallenberg's syndrome by Cheonghunhwadam-tang. Korean J. Oriental Physiology & Pathology. 2005;19(2):284-8.
  8. Jang JH, Park PJ. Comparision of the Results between Epidural Injection and Selective Nerve Root Block in Lumbar Spine Disorder. Kosin Medical Journal. 2004;19(1):175-9.
  9. Shim DM, Kim TK, Oh SK, Choi YH, Lee SJ. Effectiveness of Selective Nerve Root Block on the Need for Surgical Treatment of Lumbar Spine -A Minimum 5 Years Follow up-. J Korean Orthop Assoc. 2009;44:118-22.
  10. Choi DY, Kim JG, Yeom YH. Interpretation of Golden Chamber. 2004. Seoul:Dongguk. 164-5.
  11. Department of Rehabilitation Medicine, College of Medicine, The Catholic University. Current Principles and Clinical Practice of Rehabilitation Medicine, 2012, Seoul: Koonja. 24, 37-42, 44-5, 105-7.
  12. Cardiac internal medicine editorial committee of Korean Medicine schools. Korean Cardiology & Neurology. Seoul: Goonja medicine. 2011:404-7.
  13. Yang CS. Vascular Incidence and Vascular Spreading Pattern during Lumbosacral Transforaminal Epidural Injections. Master's Thesis of Hanyang University. 2007.
  14. Hwang SJ, Han KR, Kim SY, Kim NS, Kim C. Analysis of Intravascular Flow Patterns following Cervical Transformainal Epidural Injection. Korean J Pain. 2009;22(1);52-7.
  15. Kang BG, The Study of Research Method of Acupuncture Treatment for Stroke. Master's Thesis of Wonkwang University. 2007.
  16. National Rehabilitation Research Institute(KNRRI). The Effects of Oriental medicine in Stroke: Systematic Review. National Rehabilitation Center. 2010:83-170.
  17. Zijing Xie, Fangyuan Cui, Yihuai Zou, Lijun Bai. Acupunctrue Enhances Effective Connectivity between cerebellum and Primary Sensorimotor Cortex in Patients with Stable Recovery Stroke. Evidence-Based Complementary and Alternative Medicine. 2014:1-9.
  18. Ji SG, Cha HG, Kim MK. Stroke Recovery Can be Enhanced by using Repetitive Transcranial Magnetic Stimulation Combined with Mirror Therapy. Journal of Magnetics. 2014;19(1):28-31.
  19. Na HJ, Kwon DY. Study on the Origin, Description and Composition of Sokmyeung-tang. The Korean journal of oriental medicine prescription. 2003;11(2):19-28.
  20. Heo EJ, Lee IS, Kang HW, Jeon WK. Effects of Sokmyong-tang on Ferric Chloride-induced Carotid Injury and Thrombosis in a Rat Model. Korean J. Oriental Physiology & Pathology. 2012;25(5):732-7.