Brainstem syndromes Flashcards
webers syndrome (anterior midbrain)
ipsilateral CN3 palsy
contralateral hemiplegia
Claudes syndrome
ipsilateral CN3
contralateral cerebellar ataxia
Nothnagels syndrome
not high enough for cerebellar peduncles to cross
ipsi CN3
ipsi ataxia
Benedikts syndrome
both- combined webers and claudes
contralateral weak and clumsy limbs
contralateral tremor
Parinaud’s syndrome (dorsal midbrain)
upwards gaze paralysis
conversion- retraction nystagmus
cause of parinauds
pineal gland germinoma
tectal plate glioma
intranuclear ophthalmoplegia
common in MS
lesions the side of eye will not adduct
one and a half syndrome
total lateral gaze palsy one one side
INO on the other
cushings triad
intracranial hypertension
arterial hypertension
reflex bradycardia
hakim triad- normal pressure hydrocephalus
- wet, wacky and wobbly
dementia
gait apraxia
incontinence
argyle-robertson pupil- classic in tertiary syphillis
accommodates but does not react
holmes-adie myotonic pupil
often in young women
tonically dilated pupil
reacts more to accomodation
depressed reflexes
physiological anisocoria
normal people have one pupil bigger than the other
marcus- gunn pupil + relative afferent pupillary defect (after optic neuritis)
partial optic nerve injury
brisk movements will cause paradoxical eye dilation in light because the stronger factor will be loss of light in the other eye
Devics disease
nueromyelitis optica
optic and cervical cord demyelination
mimics MS
raymonds syndrome (base of pons)
ipsilateral CN6
contralateral hemiplegia
locked in syndrome (basilar artery thrombosis)
bilateral Raymonds
both CN 6 palsy and both hemiplegia
lateral pontine syndrome (Marie-Foix)
- Ipsilateral cerebellar ataxia due to involvement of cerebellar tracts
- Contralateral hemiparesis due to corticospinal tract involvement
- Variable contralateral hemihypesthesia for pain and temperature due to spinothalamic tract involvement
- CN 7 and 8
dejerines- medial medullary syndrome
ipsy CN 12
contralateral paralysis + vibration+ proprioception
wallenburg- lateral medullary syndrome
PICA syndrome
CN 9 , 10, 11
hemimedullary syndrome of Reinhold
medial + lateral medullary syndrome
including CN 12
brown squared syndrome
spinal cord hemisection
ipsi weakness/dorsal column
contra pain
medical 3rd nerve palsy
vascular, diabetic affects vasa nervosum
pupil sparing
surgical 3rd nerve palsy
compressive, raised ICP
non pupil sparing
Fovilles syndrome
ipsi horizontal gaze palsy
facial palsy
contralateral hemi
avellis syndrome
partial lateral medullary
vestibular nuclei + cerebellar connections spared
millard- gubler syndrome
CN 6 + 7 with contralateral hemi
top of basilar syndrome- thalamic perforators
strange behaviour
drowsiness
dream like state
eye abnormalities
artery or percheron infarct
paramedian thalamic syndrome due to vessel variant
anterior cingulotomy
pain asymbolia - feels pain but doesn’t care
foster kennedy
olfactory groove lesion
anosmia
ipsilateral optic atrophy
contralateral papilloedema
dominant side parietal lobe lesion (left)
astereogeneis - can’t identify things by touch
non dominant parietal lobe lesion (right)
anosognosia - lack of knowledge of disease (unaware they are blind)
both side parietal lesion
contralateral inferior quadrantanopia
contralateral neglect
dominant (left) temporal lobe lesion
dyslexia
agraphia
acalculia
wernickes
non dominant (right) temporal lobe(fusiform) lesion
prosopagnosia- can’t recognise faces
occipital lobe lesion
homonymous hemianopia
central vision usually spared due to dual blood supply
what can asterogenesis be associated with
cortical neglect = loss of contralateral spatial awareness
- patient denies existence of one side of body and visual field
where is the lesion for cortical neglect most likely
right superior parietal
why can damage to parietal lobe also cause apraxia
connection with premotor cortex
