Cerebellar and brainstem syndromes- definitions Flashcards
Ataxia of gait or torso, dysarthrai, nystagmus, nausea
Medial cerebellar syndrome
Ataxia, dysmetria, intention tremor of ipsilateral limbs, dysarthria, vertigo, nystagmus, nausea
Lateral cerebellar syndrome
LMN abnormalities of ipsilateral sternocleinomastoid and trapezius muscles
Accessory neuropathy
Deviation of protruded tongue toward weak side, dysarthria due to inability to enunciate lingual sounds (la)
Hypoglossal neuropathy
Dysarthria of pharyngeal consonants (ka, ha), dysphonia, dysphagia, nasal regurgitation, ipsilateral weakness of palate elevation, diminished ipsilateral efferent limb of pharyngeal reflex
Vagus neuropathy
Ipsilateral afferent limb dysfunction of gag reflex, LMN abnormalities of stylopharyngeus muscle
Rarely, parasympathetic, viscerosensory, taste abnormalities
Glossopharyngeal neuropathy
Conductive or sensorineural hearing loss, vertigo, nausea, nystagmus
Vestibulocochlear neuropathy
Sound louder in ipsilateral ear with Webers and louder on mastoid for Rhinnes
Conductive hearing loss
Sound louder in contralateral ear for Webers and louder near ear than mastoid for Rhinne’s
Sensorineural hearing loss
Ipsilateral hyperacusis, abnormal taste
Ipsilateral LMN abnormalities of upper and lower face
Ipsilateral decreased lacrimation and salivation
Facial neuropathy
In facial neuropathy, the ipsilateral hyperacusis is due to involvement of the ______
Stapedius
In facial neuropathy, the abnormal taste is due to involvement of the _____
Solitary nucleus
In facial neuropathy, the decrease in lacrimation and salivation is due to involvement of the _______
parasympathetics to glands
Somatosensory abnormalities of face, hyperacusis
LMN abnormalities of muscles of mastication
Trigeminal neuropathy
In trigeminal neuropathy, the hyperacusis is due to involvement of the ________
tensor tympany
Horizontal diplopia due to weakness of lateral rectus, worse with gaze in the direction of the weak muscle
Abnormal eye is unable to abudct
Abducens neuropathy
Ipsilateral weakness of eye depression when adducted and intorsion when abducted
Patients flex neck anteriorly and contralaterally to improve diplopia
Trochlear neuropathy
Ipsilateral ptosis, weakness of eye elevation and adduction
Aniscoria worse in light
Oculomotor neuropathy
Ipsilateral ptosis
Aniscoria worse in dark
Anhidrosis
Horner’s syndrome
Differentiate ptosis in Horner’s syndrome vs oculomotor neuropathy
Oculomotor neuropathy- levator palpebrae
Horner’s syndrome- superior tarsal muscle
Position, vibration, fine touch abnormalities in contralateral body
Pain, temp, gross touch abnormalities in contralateral face
LMN abnormalities of the ipsilateral tongue
UMN abnormalities of contralateral body
Medial medullary syndrome
In medial medullary syndrome, the position/ vibration/ fine touch abnormalities in the contralateral body are due to involvement of the _________
medial lemniscus
In medial medullary syndrome, the pain, temp, gross touch abnormalities in contralateral face are due to involvement of the __________
trigeminothalamic tract
In medial medullary syndrome, the LMN abnormalities of the ipsilateral tongue are due to involvement of the _______
hypoglossal nucleus
In medial medullary syndrome the UMN abnormalities of the contralateral body are due to involvement of the _____
pyramid
Diminished pain, temp, gross touch for ipsilateral face
Diminished pain, temp, cross touch for contralateral body (spinothalamic)
Diminished ipsilateral taste (solitary nucleus)
Vergtigo, nausea, nystagmus (vestibular nuclei)
Ipsilateral sensorineural hearing loss (cochlear nuclei)
Diminished ipsilateral afferent limb function of the pharyngeal reflex (spinal trigeminal nucleus)
Diminished ipsilateral palate elevation, dysarthria, dysphagia, dysphonia, diminished ipsilateral efferent limb of gag reflex (ambiguus nucleus)
Ipsilateral limb ataxia (inferior cerebellar peduncle)
Ipsilateral Horner’s syndrome
Usually caused by posterior inferior cerebellar artery dysfunction
Lateral medullary syndrome
In lateral medullary syndrome, the diminished pain, temp, gross touch for ipsilateral face is due to involvement of _____
spinal trigeminal nucleus
In lateral medullary syndrome, the diminished pain, temp, gross touch for contralateral body is due to involvement of the _______
spinothalamic tract
Position, vibration, fine touch abnormalities of contralateral body
Somatosensory abnormalities of contralateral face
UMN abnormalities of contralateral body Limb ataxia Ipsilateral eye abduction weakness Ipsilateral horizontal gaze paresis Ipsilateral opthalmoparesis Weakness of ipsilateral face Contralateral lower facial weakness
Medial pontine syndrome
In medial pontine syndrome, the position, vibration, fine touch abnormalities of contralateral body are due to involvement of ______
medial lemniscus
In medial pontine syndrome, the somatosensory abnormalities of contralateral face are due to involvement of the ______
trigeminothalamic tract
In medial pontine syndrome, the UMN abnormalities of contralateral body are due to involvement of the ______
corticospinal tract
In medial pontine syndrome, the limb ataxia is due to involvement of ______
corticopontine tract
In medial pontine syndrome the ipsilateral eye abduction weakness is due to involvement of _______
abducens nucleus
In medial pontine syndrome, the ipsilateral opthalmoparesis is due to involvement of _____
medial longitudinal fasciculus
In medial pontine syndrome, the weakness of ipsilateral face is due to involvement of _____
facial nucleus
In medial pontine syndrome, the contralateral lower facial weakness is due to involvement of
corticobulbar tract
Pain, temperature, gross touch abnormalities of contralateral body
Somatosensory abnormalities of ipsilateral face and ipsilateral afferent limb dysfunction of corneal reflex
Ipsilateral hyperacusis
Ipsilateral hearing loss, vertigo, nausea, nystagmus
ipsilateral upper and lower facial weakness and efferent limb dysfunction of corneal reflex
LMN abnormalities of ipsilateral muscles of mastication
Ipsilateral limb ataxia
Ipsilateral Horner’s syndrome
Lateral pontine syndrome
In lateral pontine syndrome, the ipsilateral limb ataxia is due to involvement of _____
pontocerebellar tract
In lateral pontine syndrome, the LMN abnormalities of ipsilateral muscles of mastication is due to involvement of _____
trigeminal nucleus
In lateral pontine syndrome, the ipsilateral upper and lower and upper facial weakness and the dysfunction of corneal reflex are due to involvement of _____
facial nucleus
In lateral pontine syndrome, the pain/ temp/ gross touch abnormalities in the contralateral body is due to involvement of _____
spinothalamic tract
In lateral pontine syndrome, the somatosensory abnormalities of ipsilateral face and ipsilateral afferent limb dysfunction of corneal reflex is due to involvement of _____
trigeminal nucleus
In lateral pontine syndrome, the hyperacusis is due to involvement of _____
facial and trigeminal nuclei
In lateral pontine syndrome, the ipsilateral hearing loss, vertigo, nausea, nystagmus is due to involvement of ______
vestibular or cochlear nuclei
Loss of most voluntary motor functions, may have control of eyelid elevation
Locked in syndrome
bilateral lesion of basis pontis sparing tegmentum
UMN abnormalities of contralateral arm, leg, lower face
Ptosis, dysconjugacy
Contralateral trochlear neuropathy
Contralateral limb ataxia
Dysfunction of ipsilateral efferent limb of pupillary light reflex
Medial midbrain syndrome
In medial midbrain syndrome, the UMN abnormalities of the contralateral arm, leg, and lower face are due to involvement of _________
corticospinal and corticobulbar tracts
In medial midbrain syndrome, the ptosis and dysconjugacy are due to involvement of _______
oculomotor nucleus
In medial midbrain syndrome, the contralateral trochlear neuropathy is due to involvement of the _____
trochlear nucleus
In medial midbrain syndrome the contralateral limb ataxia is due to involvement of the _______
corticopontine tract
In medial midbrain syndrome the dysfunction of the ipsilateral efferent limb of the pupillary reflex is due to involvement of the _________
EW nucleus
Somatosensory abnormalities of contralateral face, arm, leg
UMN abnormalities of contralatreral leg, arm, face
Contralateral limb ataxia
Horner’s syndrome
Lateral midbrain syndrome
In lateral midbrain syndrome, the somatosensory abnormalities of the contralateral face, arm, and leg are due to involvement of ______
trigeminothalamic, spinothalamic, medial lemniscus
In lateral midbrain syndrome the UMN abnormalities of the contralateral arm, leg, and face are due to involvement of the ______
corticospinal and corticobulbar tracts
In lateral midbrain syndrome the contralateral limb ataxia is due to involvement of ______
corticopontine tract
Monocular visual loss
Afferent pupillary defect
Retinopathy, optic neuropathy
Lesion of medial optic chiasm
Bitemporal hemianopsia
