Medial pontine syndrome

Medial pontine syndrome: Medial pontine syndrome

Classification and external resources

Pons. (Medial pontine syndrome affects structures at the bottom of the diagram: the corticospinal tract, abducens nerve, and occasionally the facial nerve. Medial lemniscus is also affected, but not pictured.)

ICD-10 G46.3

Medial inferior pontine syndrome is a condition associated with a contralateral hemiplegia.

"Medial inferior pontine syndrome" has been described as equivalent to Foville's syndrome.^[1]

Contents

1 Presentation

2 Cause

3 References

4 External links

Presentation

Although medial pontine syndrome has many similarities to medial medullary syndrome, because it is located higher up the brainstem in the pons, it affects a different set of cranial nuclei.

Structure affected Presentation

Corticospinal tract Contralateral spastic hemiparesis

Medial lemniscus Contralateral PCML loss (tactile, vibration, and stereognosis)

Abducens nerve Strabismus (ipsilateral lateral rectus muscle paralysis - the affected eye looks down and towards the nose). Abducens nerve lesion localizes the lesion to inferior pons.

Depending upon the size of the infarct, it can also involve the facial nerve.

Cause

Human brainstem blood supply description. Basilar artery is #7, and pons is visible below it.

Medial pontine syndrome results from occlusion of paramedian branches of the basilar artery.

References

^ Hubloue I, Laureys S, Michotte A (September 1996). "A rare case of diplopia: medial inferior pontine syndrome or Foville's syndrome". Eur J Emerg Med 3 (3): 194–8. PMID 9023501.

External links

http://isc.temple.edu/neuroanatomy/lab/lesions/17.htm

v · d · eCNS disease, Vascular disease: Cerebrovascular diseases (G45–G46 and I60–I69, 430–438)

Brain ischemia/
cerebral infarction
(ischemic stroke/TIA)

TACI, PACI

precerebral: Carotid artery stenosis

cerebral: MCA · ACA · Amaurosis fugax

Moyamoya disease

POCI

precerebral: Anterior spinal artery syndrome · Vertebrobasilar insufficiency (Subclavian steal syndrome)

brainstem: medulla (Medial medullary syndrome, Lateral medullary syndrome) · pons (Medial pontine syndrome/Foville's, Lateral pontine syndrome/Millard-Gubler) · midbrain (Weber's, Benedikt, Claude's)

cerebral: PCA · Lacunar stroke · Thalamic syndrome

cerebellar

General

cerebral: Cerebral venous sinus thrombosis · CADASIL · Binswanger's disease · Transient global amnesia

Intracranial hemorrhage
(hemorrhagic stroke)

Extra-axial

Epidural · Subdural · Subarachnoid

Cerebral/Intra-axial

Intraventricular

Brainstem

Duret haemorrhage

Aneurysm
Cerebral aneurysm (Intracranial berry aneurysm, Charcot-Bouchard aneurysm)

Other/general
Cerebral vasculitis

M: CNS

anat(n/s/m/p/4/e/b/d/c/a/f/l/g)/phys/devp

noco(m/d/e/h/v/s)/cong/tumr, sysi/epon, injr

proc, drug(N1A/2AB/C/3/4/7A/B/C/D)

M: VAS

anat(a:h/u/t/a/l,v:h/u/t/a/l)/phys/devp/cell/prot

noco/syva/cong/lyvd/tumr, sysi/epon, injr

proc, drug(C2s+n/3/4/5/7/8/9)

v · d · eLesions of spinal cord and brain

Spinal cord/
vascular myelopathy

sensory: Sensory ataxia · Tabes dorsalis

motor: Motor neurone disease

mixed: Brown-Séquard syndrome · cord syndrome (Posterior, Anterior, Central/Syringomyelia) · Subacute combined degeneration of spinal cord (B12) · Cauda equina syndrome
Anterior spinal artery syndrome

Brainstem

Medulla (CN 8, 9, 10, 12)

Lateral medullary syndrome/Wallenberg (PICA) · Medial medullary syndrome/Dejerine (ASA)

Pons (CN 5, 6, 7, 8)

Lateral pontine syndrome (AICA) (lateral) · Medial pontine syndrome/Millard-Gubler syndrome (basilar)/Foville's syndrome (dorsal, basilar) · Locked-in syndrome (ventral) · Internuclear ophthalmoplegia · One and a half syndrome

Midbrain (CN 3, 4)

Weber's syndrome (ventral peduncle, PCA) · Benedikt syndrome (ventral tegmentum, PCA) · Parinaud's syndrome (dorsal, tumor) · Nothnagel's syndrome · Claude's syndrome

Other

Alternating hemiplegia

Cerebellum
lateral (Dysmetria, Dysdiadochokinesia, Intention tremor) · medial (Cerebellar ataxia)

Basal ganglia
Chorea · Dystonia · Parkinson's disease

Cortex

ACA syndrome · MCA syndrome · PCA syndrome

frontal lobe: Expressive aphasia · Abulia

parietal lobe: Receptive aphasia · Hemispatial neglect · Gerstmann syndrome · Astereognosis

occipital lobe: Balint's syndrome · Cortical blindness · Pure alexia
temporal lobe: Cortical deafness · Prosopagnosia

Other
Subclavian steal syndrome · Upper motor neurone lesion (Clasp-knife response) · Lower motor neurone lesion

M: CNS

anat(n/s/m/p/4/e/b/d/c/a/f/l/g)/phys/devp

noco(m/d/e/h/v/s)/cong/tumr, sysi/epon, injr

proc, drug(N1A/2AB/C/3/4/7A/B/C/D)

Categories:
Disease stubs
Stroke

Medial pontine syndrome
Classification and external resources
Pons. (Medial pontine syndrome affects structures at the bottom of the diagram: the corticospinal tract, abducens nerve, and occasionally the facial nerve. Medial lemniscus is also affected, but not pictured.)
ICD-10	G46.3

Structure affected	Presentation
Corticospinal tract	Contralateral spastic hemiparesis
Medial lemniscus	Contralateral PCML loss (tactile, vibration, and stereognosis)
Abducens nerve	Strabismus (ipsilateral lateral rectus muscle paralysis - the affected eye looks down and towards the nose). Abducens nerve lesion localizes the lesion to inferior pons.

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Medial pontine syndrome

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Cause

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External links

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Medial pontine syndrome

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Presentation

Cause

References

External links

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