Syndrome Of Brainstem

Question 1

Medial medullary syndrome

Answer 1

1. Medial lemniscus—>Contralateral loss of position, vibratory sense, discriminative touch over entire body.
2. Corticospinal fivers—> contralateral flaccid hemiplegia of U/LL, decreased reflexes, babinski sign
3. Intramedullary hypoglossal rootlets—> paresis of tongue, deviates to side of lesion.

Question 2

Lateral medullary syndrome

Answer 2

1. Spinothalamic fibers—> Contralateral loss pain, temp
2. Spinal trigeminal tract and nucleus—> ipsilateral loss of pain/T on face
3. Nucleus ambiguus—> difficultly in swallowing/speech
4. Cochlear nuclei—> ipsilateral diminution (hearing loss)
5. Vestibular nuclei—> nystagmus, nausea, ataxia to side of lesion
6. Autonomic fibers—> horner syndrome

Question 3

Tumor of midbrain

Answer 3

Blocks the cerebral aqueduct —> hydrocephalus and involvement of CN3,4

Question 4

Benedikt syndrome

Answer 4

Involves red nucleus and medial lemniscus

Contralateral hemianesthesia
Involuntary movement of limbs contralaterally