PONS MESEN CLINICAL Flashcards
Caudal Basal Pontine Syndromes
MILLARD-GUBLER SYNDROME-6,7,CST
GELLÉ - 7, 8, CST
BRISSAUD-SICARD SYNDROME- ipsilateral facial hemispasm and contralateral hemiparesis
Rostral Basal Pontine Syndrome
Motor Hemiparesis: CST at basis
Ataxic Hemiparesis: corticospinal tract fascicles along with pontocerebellar fascicles
Dysarthria–Clumsy Hand Syndrome: central (supranuclear) facial weakness, severe dysarthria and dysphagia, hand paresis, and clumsiness.
The Locked-in Syndrome
Crying and Laughter:
TEGMENTAL PONTINE SYNDROMES
Medial Tegmental Syndrome: cranial nerve VI), the genu of the facial nerve, and the medial lemniscus
1 1/2 syndrome: abducens nucleus and the medial longitudinal fasciculus
Dorsolateral Tegmental Pontine Syndrome
dissociated sensory loss (loss of pain and temperature sense with preservation of vibration and position sense) enveloping the entire body, accompanied by truncal and limb ataxia without weakness.
ST, Trigeminal lemniscal, cerebellar
Caudal Tegmental Pontine Syndromes
FOVILLE’S SYNDROME (RAYMOND-FOVILLE SYNDROME): (contralateral hemiparesis), the paramedian pontine reticular formation (PPRF), and/or the abducens nucleus (conjugate gaze palsy
MUSICAL HALLUCINOSIS: acoustic striae (including the trapezoid body), superior olivary nucleus, lateral lemniscus. release of auditory memories by disinhibition of reticular pathways from nucleus raphe pontis to sensory centers in the thalamus and cerebral cortex.
Mid-Tegmental Pontine Syndrome (Grenet Syndrome)
trigeminal nucleus and trigeminothalamic fibers, superior cerebellar peduncle, and spinothalamic tract, and it extends ventrally to involve corticospinal fibers.
Rostral Tegmental Pontine Syndrome (Raymond-Cestan-Chenais Syndrome)
medial lemniscus, medial longitudinal
, spinothalamic tract, and cerebellar fibers.
Extreme Lateral Tegmental Pontine Syndrome (Marie-Foix Syndrome)
ipsilateral cerebellar ataxia and contralateral hemiparesis with or without hemisensory loss.
Ocular Bobbing and Dipping
ocular bobbing, inverse ocular bobbing, ocular dipping, and inverse ocular dipping
characterized by sustained tachypnea that persists despite an elevated arterial PO2 and pH and a low arterial PCO2
pontine lesion of this type disinhibits inhibitory pontine influences on medullary respiratory neurons
Central Neurogenic Hyperventilation
Paremedian infarcts of MB:
Lateral infarcts of MB:
nuclear
fascicular
Weber, cerebral peduncle
ipsilateral oculomotor nerve paralysis and contralateral upper motor neuron paralysis that includes the lower face
Syndrome of Benedikt,
tegmentum, red nucleus
ipsilateral oculomotor nerve paralysis and contralateral tremor
low frequency and may have resting, postural, and kinetic components
component of the tremor responds well to treatment with levodopa.
rubral tremors
Claude’s Syndrome
medial half of the red nucleus, the adjacent decussating fibers of superior cerebellar peduncle, and oculomotor nerve fascicles.
Nothnagel’s Syndrome
oculomotor nerve fascicles and the brachium conjunctivum.
Plus-Minus Lid Syndrome
Rostral midbrain involving the nucleus of the posterior commissure and oculomotor fascicles to the ipsilateral levator palpebrae muscle as they emerge from the central caudal subnucleus.
Walleyed Syndrome
alleyed bilateral internuclear ophthalmoplegia (WEBINO) syndrome.
lateral deviation of both eyes (exotropic gaze) and the absence of ocular adduction.
Vertical One-and-a-Half Syndrome
bilateral impairment of downgaze (the one) and monocular paralysis of elevation (the half)
efferent tracts of the rostral interstitial nucleus of the medial longitudinal fasciculus (RiMLF) bilaterally
and premotor fibers to the contralateral superior rectus subnucleus and the
ipsilateral inferior oblique subnucleus before or after decussation in the posterior commissure.
Top of the Basilar Syndrome
Balint’s syndrome (optic ataxia) caused by involvement of the occipital, parietal, and temporal cortices,
vertical gaze abnormalities, lid retraction (Collier’s sign), and convergence disordeR
light-near dissociation and a small reactive or large fixed pupil,
behavioral disturbances (somnolence, memory defects, agitation, hallucination)
Peduncular Hallucinosis Syndrome
nonthreatening hallucinations, often formed nonstereotypically, colored, and vivid,
tegmental and cerebral peduncle lesions.
akinetic mutism (Cairns syndrome),
Bilateral limited lesions of the mesencephalic reticular formation
absolute mutism and complete immobility except for the eyes, which are kept open and move in all directions
The condition is also known as persistent vegetative state.
brain stem caudal to the red nucleus and rostral to the vestibular nuclei
decerebrate rigidity
