According to bittranslators.com, Jackson syndrome is a brainstem or alternans syndrome with crossed paralysis symptoms, also known as ventral paramedian oblongata syndrome. The cause of the phenomena is a stroke in the area of the flow of the vertebral artery. The treatment is symptomatic supportive and consists mainly of physiotherapeutic and speech therapy measures.
What is Jackson Syndrome?
Most patients with Jackson Syndrome suffer from severe paralysis and other sensory disturbances, usually affecting the entire body. This causes severe movement restrictions, which lead to a reduced quality of life.
Damage to the brainstem causes so-called alternans syndrome. These syndromes are characterized by crossed symptoms of paralysis and occur with unilateral lesions of the brainstem structures. The clinical pictures fall into the group of brainstem syndromes.
Characteristic is the ipsilateral loss of cranial nerves and the hemiparesis of the opposite half of the body, which is associated with sensory disturbances. Depending on the exact localization of the damage, there are different types of brainstem or alternans syndromes. A subtype is Jackson syndrome, which is associated with unilateral damage to the pyramidal tract and the hypoglossal nerve nucleus.
The damaged nerve nucleus is located in the ventral portion of the medulla oblongata, which is why Jackson syndrome is also known as ventral paramedian oblongata syndrome. Jackson syndrome is characterized by tongue paralysis on the side of the brainstem lesion and hemiplegia on the opposite side. The term Jackson syndrome goes back to the English neurologist JH Jackson, who first described the syndrome in the 19th century and named bleeding in the medial medulla oblongata as the cause.
In most cases, Jackson syndrome is the result of a stroke. This stroke usually occurs within the flow area of the vertebral artery. Due to the proximity to the pyramidal tract, this motor structure is affected, resulting in hemiparesis on the opposite side of the body.
From the point where the pyramids cross, the two sides of the brain each supply the opposite half of the body. However, the cranial nerve structures above the pyramidal junction are controlled by the cerebral hemispheres of the side that feed them. For this reason, the stroke in Jackson syndrome causes paralysis of the opposite extremities, but at the same time paralysis of the cranial nerve structures on the side of the lesion.
These nerves include the hypoglossal nucleus, which lies in the ventral part of the medulla oblongata and supplies the tongue with its branches. The cause of the lesion in Jackson syndrome is always a local micro-angiopathic change or an embolic occlusion in the end sections of the vertebral artery. Both events cause ischemia, which is to be understood as the primary cause of the crossed symptoms of paralysis.
Symptoms, Ailments & Signs
Like all other alternans syndromes, Jackson syndrome manifests itself clinically in the form of crossed paralysis. Paralysis of the tongue occurs ipsilateral to the causative brainstem lesion, which is motor-innervated by the hypoglossal nerve and leads to the hypoglossal nucleus.
Hemiplegia with sensory disturbances occurs on the body side of the brain lesion opposite the hemiparesis, which can be attributed to damage to the pyramidal tract above the pyramidal junction. The sensory disturbances in Jackson syndrome can manifest themselves in different ways. In addition to numbness, tingling or burning may occur.
Hypersensitivity is also conceivable, but not the norm. The severity of the hemiplegia depends on the extent of the brain damage. Due to the paralysis of the tongue, those affected sometimes have difficulty eating and drinking. The pronunciation is also more or less alienated because of the one-sided tongue paralysis.
Diagnosis & course of disease
The neurologist usually makes the first suspected diagnosis of Jackson syndrome because of the characteristic symptoms based on the clinical picture. Nevertheless, a differential diagnosis from other brainstem syndromes is necessary as part of the diagnosis.
A brainstem syndrome that occurs much more frequently after brain damage in the region of the medial medulla oblongata is the Dejerine-Spiller syndrome, which deserves the greatest attention in terms of differential diagnosis. Jackson syndrome is essentially a reduced form of Dejerine-Spiller syndrome.
In addition to the symptoms of Jackson syndrome, the full Dejerine-Spiller syndrome also includes a significant sensory disturbance on the side of the hemiplegia. The patient’s sensitivity to pain and temperature is preserved because of the lesion within the dorsal column. In comparison, patients with Jackson syndrome have a relatively favorable prognosis.
Most patients with Jackson Syndrome suffer from severe paralysis and other sensory disturbances, usually affecting the entire body. This causes severe movement restrictions, which lead to a reduced quality of life. In most cases, these restrictions also lead to psychological problems or depression.
It is not uncommon for patients to be dependent on the help of other people in their everyday lives. Furthermore, there is the typical tingling and numbness in the affected areas. In some cases, hypersensitivity also occurs. Paralysis of the tongue and mouth in particular can lead to difficulties in eating and drinking, so that the person concerned loses weight or suffers from dehydration.
As a rule, Jackson syndrome cannot be treated causally. For this reason, only symptomatic treatment takes place. However, this does not always lead to a positive course of the disease. Life expectancy can be limited by the causative disease. With the help of various therapies, however, some symptoms can be limited and treated.
When should you go to the doctor?
In a large number of cases, patients who have suffered a stroke suffer from sequelae and life-long health impairments. Jackson syndrome is among the effects of the life-threatening condition and should be treated therapeutically. A doctor must be notified in the event of discomfort in the mouth area. Tongue paralysis or loss of tongue control is considered a concern and should be evaluated by a doctor.
If signs of paralysis appear on one side, disturbances in sensory perception set in or limitations in sensitivity are noticed, the observations should be discussed with a doctor. A tingling sensation on the skin or burning sensations are among the clues that point to Jackson syndrome. In order to be able to initiate suitable therapeutic measures, a doctor should be consulted. Mobility limitations, changes in speech and eating disorders must be presented to a doctor.
If the impairments lead to weight loss or a reduced intake of liquids, there is a risk of the organism being undersupplied. In order not to trigger another life-threatening situation, a doctor must be alerted in good time. In severe cases, dehydration can occur without medical intervention, increasing the risk of premature death. If, in addition to the physical symptoms, psychological symptoms also set in, a doctor or therapist should be contacted.
Treatment & Therapy
Causal treatment is excluded for patients with Jackson syndrome. The brain damage has taken place and cannot be repaired causally. The human brain is not able to fully regenerate after damage because its tissue consists of highly specialized nerve cells.
While other tissues in the body can partially regenerate completely by absorbing new cells, this is impossible for brain tissue. Although the brain defect cannot be reversed, patients with Jackson syndrome can recover from their symptoms. Physiotherapy and speech therapy play a particularly important role in this recovery.
These supportive treatment measures consistently demand from the patient the functions that should actually take place in the damaged areas of the brain. This training stimulates nerve cells in the immediate vicinity of the brain lesion to take over the functions of the defective region.
At least an improvement in the symptoms can therefore be expected. In many cases, the patients even overcome the symptoms completely. A reduction in stroke risk factors should be aimed at so that no further brain damage is to be expected in the future.
Outlook & Forecast
The prognosis of Jackson syndrome is unfavorable. The syndrome develops as a result of a stroke. This resulted in irreversible brain damage. For this reason, symptomatic treatment of the individually occurring complaints is necessary. The aim of the therapy is to improve the existing quality of life. A cure is almost impossible. In targeted training, exercises are carried out that are intended to alleviate the symptoms. However, despite best efforts, acquired paralysis cannot be completely regenerated. In many cases, the patient is dependent on daily help from others.
The disease often leads to sequelae. Since the mental and psychological stress due to the existing symptoms is very high, it can lead to a mental illness. A large number of patients experience depressive states. These can be temporary or permanent in nature. A severe loss of well-being is also frequently documented. Coping with everyday tasks can no longer be carried out entirely by the patient himself. A restructuring of the usual processes is required.
With paralysis of the tongue, a sufficient supply of fluid is necessary, otherwise a life-threatening condition will develop. People who have had a stroke and developed Jackson syndrome may have a reduced life expectancy.
Jackson syndrome can be prevented by the same measures that apply to stroke prevention. In addition to abstaining from tobacco consumption, the reduction of obesity, diet and a sufficient amount of exercise are to be mentioned as preventive measures. The reduction of stress can also be counted among the preventive measures in the broadest sense.
In most cases, those affected with Jackson syndrome have no or only a few options and measures for direct aftercare. First and foremost, the disease must be recognized and treated quickly and, above all, early on by a doctor so that further complications or other symptoms do not occur.
The priority in Jackson syndrome is therefore early detection and treatment of the disease so that further deterioration of the symptoms can be prevented. As soon as the first symptoms of the syndrome appear, a medical professional should be contacted. In most cases, the syndrome is treated by taking various medications. The person concerned should always pay attention to the correct dosage and, above all, to taking the medication regularly.
If anything is unclear or if you have any questions, consult a doctor first. Physiotherapy or physical therapy measures are also often necessary. Many of the exercises can also be repeated at home, which may speed up the healing of Jackson syndrome. Not infrequently, contact with other patients with the disease can also be very useful, as this leads to an exchange of information.
You can do that yourself
In addition to the medical treatment measures, the symptoms of Jackson syndrome can also be treated independently under certain circumstances.
The sensory disturbances can be alleviated by regular exercise with an exercise ball or other aids, in addition to physiotherapy. Massages sometimes help against numbness and tingling. Alternative measures such as acupuncture or methods of Chinese medicine are also possible, but should be discussed in advance with the responsible doctor. Logopedic measures and targeted speaking exercises help against slurred pronunciation . Although the causal paralysis of the tongue cannot be treated in this way, the symptoms can often be reduced. Since Jackson syndrome is usually also associated with psychological problems,therapeutic support should be consulted.
In order to avoid another stroke, lifestyle changes sometimes have to be made. Those affected should refrain from nicotine, alcohol and other stimulants and from now on eat a healthy and balanced diet. Getting enough exercise is an important preventive measure. Stress and physical or mental strain should be avoided or at least reduced if possible. The doctor in charge will support the patient in implementing these changes and can give further self-help tips.