Midbrain Syndromes

Question 1

Claude Syndrome

Answer 1

Vessel: posterior cerebral artery

Involvement:
CN 3, rubrodentate fibres, corticospinal tract, cortibulbar

Deficit:
Ipsilateral
- CN3 palsy

Contralateral hemiplegia
- lower facial muscle
- Tongue weakness
- Shoulder, upper and lower limb weakness
- Ataxia

Question 2

Benedikt Syndrome
(Dorsal midbrain syndrome)

Answer 2

Vessel: posterior cerebral artery, paramedian branches of basilar artery

Involvement:
CN3, red nucleus

Deficit:
Ipsilateral
- CN3 palsy

Contralateral
- Choreoathetosis
- Tremor
- Ataxia

Question 3

Nothnagel Syndrome

Answer 3

Cause: quadrigeminal neoplasms (and often bilateral)

Involvement:
CN3, superior cerebellar peduncle

Deficit: often bilateral
Ipsilateral
- CN3 palsy
- Limb ataxia

Question 4

Weber Syndrome
(Ventral midbrain syndrome)

Answer 4

Vessel: paramedian branches of posterior cerebral artery

Involvement:
CN3, cerebral peduncle (corticospinal and corticobular tract), substantia nigra

Deficit:
Ipsilateral
- CN3 palsy

Contralateral hemiplegia
- Lower facial muscle
- Tongue
- Shoulder, upper and lower limb
- Movement disorder