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3 NERVOUS SYSTEM > Brainstem SYNDROMES > Flashcards

Brainstem SYNDROMES Flashcards

1
Q

Rule of 4 in Brainstem

A

4 CN arise from Cerebrum & Midbrain: 1,2,3,4
4 CN arise from PONS: 5,6,7,8
4 CN arise from Medulla: 9,10,11,12

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2
Q

Only Cranial Nerve to arise from DORSAL Aspect of MIDBRAIN

A

Cranial Nerve 4

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3
Q

Which Cranial nerves arise from Midline
🧠⚡ Rule of 12; Number whose multiple is 12⚡

A

3,4,6,12

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4
Q

Which Cranial nerves arise from Lateral Part of Brainstem

A

5,7,8,9,10,11

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5
Q

MEDIAL LONGITUDINAL FASICULUS
(MLF) connects
🧠⚡SEX with 3 others ⚡

A

6th CN with C/L 3rd CN nucleus

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6
Q

In Any Brainstem Syndrome, most Characteristic is

A

CROSSED HEMIPLEGIA

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7
Q

⭐ MIDBRAIN is supplied by
⭐ PONS is supplied by
⭐ MEDULLA is supplied by

A

⭐ MIDBRAIN is supplied by
🎯 P1 of Posterior Cerebral Artery (PCA)

⭐ PONS is supplied by
🎯 Medial Pontine: BASILAR Artery
🎯 Lateral Pontine: AICA

⭐ MEDULLA is supplied by
🎯 MEDIAL MEDULLARY: Anterior Spinal Artery
🎯 LATERAL MEDULLARY: PICA

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8
Q

Midbrain @ SUPERIOR COLLICULUS

🧠⚡Only MIDBRAIN Cross section to be remembered ⚡

A
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9
Q

Midbrain section @ INFERIOR COLLICULUS

A
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10
Q

How to differentiate Superior & Inferior COLLICULUS

A

At Superior COLLICULUS: 3rd CN seen
At Inferior COLLICULUS: 4th CN seen

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11
Q

Midline structures of BRAINSTEM
🧠⚡4M⚡
🧠⚡Midline = Motor ⚡

A

✨ Motor CN 3,4,6,12
✨ Medial Longitudinal FASICULUS
✨ Medial Leminiscus ➡️ DCML ➡️ VIBRATION & PROPRIOCEPTION
✨ Motor Fibers of Corticospinal Tract ➡️ C/L HEMIPLEGIA

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12
Q

Lateral structures of BRAINSTEM
🧠⚡4S⚡
🧠⚡Sides = Sensory ⚡

A
  1. Spinocerebellar Fibers ➡️ ATAXIA
  2. Spinal Leminiscus (Spinothalamic Tract) ➡️ Carry PAIN & TEMPERATURE from OPPOSITE SAIDE
  3. Spinal nucleus of Trigeminal nerve
  4. Sympathetic Fibers ➡️ HORNER’S Syndrome
  5. CN 5,7,9,10,11
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13
Q

Midbrain Syndromes
🧠⚡all have I/L 3rd CN Palsy ⚡

A

Ventral Midbrain
1. Weber’s
2. Benedikt’s
3. Claude

Dorsal Midbrain
4. Parinaud
5. Nothnagel

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14
Q

I/L Occulomotor Nerve Palsy
➕
C/L Hemiplegia

A

Weber’s syndrome

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15
Q

I/L Occulomotor Nerve Palsy
➕
C/L Bobbing Head Movement (Red Nucleus Involvement) or C/L ATAXIA
➕
C/L HEMIBALLISMUS

🧠⚡B for B⚡

A

Benedikt’s Syndrome

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16
Q

NOTHNAGEL Syndrome
🧠⚡North is Superior ⚡
🧠⚡noThnagel ⚡

A

TECTUM Involvement ➕
✨ Ataxia
✨ Paralysis of Gaze

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17
Q

CLAUDE Syndrome
🧠⚡C = Combination ⚡
🧠⚡BNC⚡

A

Combination of Benedikt’s ➕ NOTHNAGEL syndrome

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18
Q

PARINAUD’S SYNDROME
🧠⚡ParinauD ⚡

A

✨ Pineal Gland related Tumour
Involves 2P:
🎯 Pretectal Nucleus
🎯 Periaqueductal Gray Matter

✨ Dorsal Part Compression (contain Superior COLLICULUS)
⬇️
Superior Gaze Palsy
Sunset sign
Skew Deviation
Collier’s sign

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19
Q

SUNSET sign seen in

A
  1. PARINAUD’S SYNDROME
  2. Hydrocephalus
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20
Q

Collier’s Sign is seen in

A

PARINAUD’S SYNDROME
✨ Lid Retraction

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21
Q

⚡⚡ MOST COMMON MIDBRAIN SYNDROME

A

Weber’s SYNDROME

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22
Q

PONTINE SYNDROMES
🧠⚡MRF Locked In⚡

A
  1. MILLARD GUBLER SYNDROME
  2. RAYMOND SYNDROME
  3. FOVILLE Syndrome
  4. Locked in Syndrome
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23
Q

Cranial Nerves arising from PONTOMEDULLARY JUNCTION

24
Q

If Cranial nerves 6, 7, 8 lesioned, lesion lies at

A

Lower Level of Pons

25
Q

Millard GUBLER SYNDROME
🧠⚡ 7 letters & 6 letters⚡

A

6th & 7th CN palsy
Spares the NUCLEUS only affects the Nerve Fibers

26
Q

FOVILLE SYNDROME
🧠⚡ 7 letters⚡

A

7th CN Palsy
➕
Lateral Gaze Palsy

27
Q

RAYMOND Syndrome
🧠⚡Ond = 1 nerve only ⚡

A

6th CN affected

28
Q

LOCKED IN SYNDROME

A

B/L Ventral PONTINE Involvement

29
Q

Medial Medullary Syndrome
Synonym

A

Dejerine Syndrome

30
Q

Features of DEJERINE Syndrome
🧠⚡4M⚡

A
  1. Cranial Nerve 12 affected ➡️ Gets DEVIATED to same side
  2. Medial Leminiscus affected ➡️ C/L Proprioception Loss
  3. Motor Corticospinal Tract affected ➡️ C/L Hemiplegia
  4. MLF lesion ➡️ Intranuclear Opthalmoplegia
31
Q

⭐ PICA Involvement leads to

⭐ AICA Involvement leads to

A

⭐ PICA Involvement leads to
🎯 Lateral Medullary Syndrome

⭐ AICA Involvement leads to
🎯 Lateral Pontine Syndrome

32
Q

AICA Involvement

🧠⚡fACIAl⚡

A

7th CN palsy
➕
SNHL (DUE TO: Labyrinthine artery Involvement)

33
Q

Wallenberg syndrome
Synonyms

A

✨ Lateral Medullary Syndrome
✨ PICA syndrome

34
Q

Features of Wallenberg Syndrome
🧠⚡ 5S⚡

A
  1. Spinal Nucleus of Trigeminal Nerve ( 5th CN) affected ➡️ I/L Face Sensation Lost
  2. Nucleus Tractus Solitarius affected ( 7th CN) ➡️ Loss of Taste in Anterior ⅔rd of Tongue
  3. Nucleus ambiguus affected ( 9th & 10th CN) ➡️ Palatal Palsy, Dysphagia, Hoarseness, Nasal Regurgitation
  4. Spinocerebellar fibers affected ➡️ I/L Ataxia
  5. Spinothalamic Fibers affected ➡️ C/L Pain & Temperature
  6. Sympathetic abnormalities
35
Q

PICA Involvement

🧠⚡PICAchew ⚡

A

Chewing Difficulty ➡️ Dysphagia in Lateral Medullary Syndrome

36
Q

Identify

A

Medulla Oblongata Cross Section

37
Q

Identify

A

Weber Syndrome

38
Q

Identify

A

Benedikt’s Syndrome

39
Q

Identify

A

Claude’s symdrome

40
Q

Causes of ARGYLL ROBERTSON PUPIL

A
  1. Neurosyphilis
  2. PARINAUD’S SYNDROME
41
Q

Pretectal Nucleus is responsible for

A

Light Reflex Pathway

42
Q

ARGYLL ROBERTSON PUPIL
🧠⚡ ARP , PRA⚡

A

Accomodation Reflex Present
Positive Light Reflex Absent

43
Q

Marie Foix Syndrome

A

Lateral Pontine Syndrome

44
Q

Avellis Syndrome

A

10th CN ➡️ Paralysis of Soft Palate & Vocal Cord
➕
Spinothalamic Tract ➡️ C/L Hemianesthesia

45
Q

Site of AVELLIS Syndrome & Jackson Syndrome

A

Tegmentum of Medulla

46
Q

Jackson Syndrome

A

Avellis syndrome
➕
I/L 12th CN palsy ➡️ Tongue Syndrome

47
Q

Cruciate Paralysis
Meaning

A

Arm weakness on 1 SIDE
➕
Leg Weakness on Other SIDE

48
Q

⚡⚡ MOST COMMON CAUSE OF LATERAL MEDULLARY Syndrome

A

V4 Segment of VERTEBRAL ARTERY > PICA

49
Q

Pseudo Abducent Nerve Palsy seen in
⭐ CAUSE

A

Parinaud’s syndrome

Cause: CONVERGENT CENTER Overactivity

50
Q

Convergent Refractive Nystagmus seen in

A

Parinaud’s syndrome

51
Q

⭐ Parinaud’s Syndrome is Caused DUE TO:

⭐ Parinaud’s Occuloglandular Syndrome is Caused DUE TO:

A

⭐ Parinaud’s Syndrome is Caused DUE TO:
🎯 Pinealoma

⭐ Parinaud’s Occuloglandular Syndrome is Caused DUE TO:
🎯 Francisella Tularensis (Tularemia)

52
Q

Cause of COLLIER’S Sign

A

Overactive LPS
⬇️
DUE TO: End neurons

53
Q

Everything is lost I/L in WALLENBURG Syndrome, except

A

C/L Pain & Temperature
Spinothalamic Fibers

54
Q

What is considered as Cranial Nerve 13

A

Sympathetic chain

55
Q

Which Lateral Nerve is spared in WALLENBURG Syndrome

A

CN 11
LOCATED VERY DOWN

3 NERVOUS SYSTEM (40 decks)

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