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Wallenberg's syndrome following neck manipulation

Department of Neurology, University of California at Los Angeles, CA.

We describe 4 patients ages 28 to 41 with lateral medullary infarction (Wallenberg's syndrome) following chiropractic neck manipulation. In 3 patients, angiography documented dissection of the extracranial 3rd segment of the vertebral artery near the atlantoaxial joint. The onset of neurologic symptoms following manipulation varied from immediate to 4 days. All had good recovery with minor residual deficits. Although the association between chiropractic neck manipulation and vertebral-basilar artery distribution infarction is well known, we emphasize its occurrence in young healthy individuals without commonly regarded predisposing factors.

Address correspondence and reprint requests to Dr. Robert Baloh, Reed Neurological Research Center, UCLA, 710 Westwood Plaza, Los Angeles, CA 90024.

Received July 24, 1989. Accepted for publication in final form September 7, 1989.

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