Brainstem Lesions

Question 1

Dejerine syndrome

Answer 1

medial medullary syndrome
ASA

ML/CST/CN 12 n/nuc

ipsi tongue paralysis
contra hemiplegia body
contra loss of disc touch/vib/position sense of body

Question 2

Millard Gubler Syndrome

Answer 2

lateral pontine
AICA

cn 7 nuc, cn 5 motor nuc, HTS fibers, spinal v tract/nuc, ALS,

Ipsilateral - paralysis of face, masticatory m, horners, pain/temp from face 
contralateral - pain/temp from body 
paralysis of conjugate horizontal gaze
ataxia, fall toward side lesion
N/V/Nsytamus/deaf/vertigo/tinnitus

Question 3

raymond or foville syndrome

Answer 3

medial pontine
paramedian of basilar

CST/ML/CN 6 n or nuc/PPRF

contral hemiplegia of body
contra position/vib/discrim touch of body
ipsi LR m paralysis
paralysis of conjugate gaze toward side of lesion

Question 4

Weber syndrome

Answer 4

cerebral puduncle
midbrain/PCA

CST/CBT/5 nerve

contra hemiplegia
ipsi paralysis of masticatory m, ipsi loss of pain/temp face
down and out gaze, dilated pupil

Question 5

parinauds

Answer 5

pineal gland tumor
hit SC
can’t look up, vertical gaze loss

Question 6

wallenberg syndrome

Answer 6

lateral medullary syndrome
PICA

nucleus ambiguus, vestibular nuclei, ALS, spinal V tract/nuc

ipsi loss of pain/temp face
dysphagia/hoarse
contra uvula 
nystagmus, vertigo, nausea
contra loss pain/temp of body

Question 7

claude

Answer 7

red nucleus syndrome
midbrain/PCA
central midbrain lesion

oculomotor n, red nuc, cerebellothalamic fibers

ipsi paralysis of eye move, down and out, dilated
no vertical saccades
contral ataxia and tremor

Question 8

benedikts

Answer 8

claudes and webers

contra hemiplegia, ipsi paralysis of eye movement, dilated pupil, cerebellar ataxia