7.3. NEUROLOGICAL MANIFESTATION IN BRAINSTEM LESIONS - Pain Clinic

+7 499 135-16-82
+7 499 394-58-57
P
ain clinic
City Clinic
Hospital
No. 64
Go to content

7.3. NEUROLOGICAL MANIFESTATION IN BRAINSTEM LESIONS

Colleagues > Handbooks > Neurological examination and topical diagnosis > Section II. Topical diagnosis of focal lesions in the nervous system > Chapter 7. Syndromes caused due to brain lesions
   Syndromes caused due to brainstem lesions include symptoms due to lesion in midbrain, pons and medulla oblongata.

Midbrain disorder syndrome

 

Symptoms associated with a lesion of III and ΙV cranial nerve nuclei, auditory nuclei of VΙΙΙ cranial nerve, tractus tectospinals, fronto-cerebellopontine and occipital-cerebellopontine tracts, pyramidal pathway, the nucleus of the substantia nigra, red nucleus, medial longitudinal fasciculus and the medial leminiscus.

 

Collicular disorder syndrome

1.     Upward and downward gaze palsy.

2.     Vertical nystagmus.

3.     Incoordination in movements of the eyeballs.

4.     Ophthalmoplegia.

5.     Nothnagel’s syndrome (dysequilibrium, impaired hearing, paralysis of the oculomotor muscles, choreic hyperkinesis).

6.     Paresis and paralysis of limbs.

7.     Cerebellar disorders.

8.     Decerebrate rigidity is associated with involvement mesencephalic centers which regulate the muscle tone below the red nucleus.

Red nucleus syndromes

1.     Intentional hemitremor.

2.     Hemihyperkinesis.

 

а) Claudes syndrome (lower red nucleus syndrome)

1.     Impairment of the oculomotor nerve on same side as that of the lesion.

2.     Intentional hemitremor, hemiataxia on opposite side as that of the lesion.

 

b) Foix syndrome (upper red nucleus syndrome)

1.      Intentional hemitremor, hemihyperkinesis.

Alteranting Weber’s syndrome

1.     Lesion of the oculomotor nerve on same side as that of the lesion.

2.     Central hemiplegia on opposite side as that of the lesion.

 

Alteranting Benedict’s syndrome

1.     Lesion of the oculomotor nerve on same side as that of the lesion.

2.     Intentional hemitremor, hemihyperkinesis on opposite side as that of the lesion.

Pontine disorder syndrome (Pons varolii)

   Symptoms are associated with lesions of V, VΙ, VΙΙ and VΙΙΙ nerve nuclei, the medial leminiscus, pyramidal pathway and posterior longitudinal fasciculus.

Millard–Gubler’s alternating syndrome
1. Peripheral paralysis of the facial nerve on same side as that of the lesion.
2. Central hemiplegia on opposite side as that of the lesion.

Foville’s alternating syndrome
1. Peripheral paralysis of the facial and abducens nerve on same side as that of the lesion.
2. Central hemiplegia on opposite side as that of the lesion.

Medulla oblongata disorder syndrome

 

Symptoms caused by lesions in ΙX, X, XΙ and XΙΙ nerves nuclei, inferior olives, spinothalamic tract, nucleus of Gol and Burdach, pyramidal pathway, descending sympathetic fibers to cilospinal center and Flechsig’s tract (posterior spinocerebellar tract) & Gower’s tract (anterior spinocerebellar tract).

 

1.    When the lesion is localized in the pyramidal decussation causes alternating hemiplegia (paralysis of the arm on the affected side, leg - on the opposite side).

2.    Lesion in caudal end of medulla oblongata is accompanied by respiratory failure (respiratory paralysis, dysrhythmia and impaired respiration rate) and cardiovascular impairment.

3.    Bulbar syndrome (lesion in ΙX, X and XΙΙ cranial nerves nuclei), see page

 

Jackson’s alternating syndrome/ Medial medullary syndrome

1.    Peripheral paralysis of XΙΙ cranial nerve (paralysis and atrophy on half of the tongue and deviation of tongue) on same side as that of the lesion.

2.    Central hemiplegia on the opposite side.

 

Avelli's alternating syndrome

1.    Lesion of ΙX, X and XΙΙ cranial nerve nuclei (bulbar palsy) on same side as that of the lesion.

2.    Central hemiplegia on the opposite side.

 

Schmidt’s alternating syndrome

1.    Lesion of ΙX, X, XI and XΙΙ cranial nerve nuclei (bulbar palsy combined with paresis and atrophy of the trapezium and sternocleidomastoid muscle) on same side as that of the lesion.

2.    Central hemiplegia on the opposite side.

 

Wallenberg-Zakharchenko syndrome/ Lateral medullary syndrome

Clinically manifested when there is decreased circulation in the posterior inferior cerebellar artery

1.    Paralysis of soft palate and vocal cords (lesion in n. Ambigus, n. Vagi) on same side as that of the lesion.

2.    Horner's syndrome (lesion in descending sympathetic fibers going to the smooth muscles of the eye) on same side as that of the lesion.

3.    Vestibulo-cerebellar disorders (lesion in corpora restiformia) on same side as that of the lesion.

4.    Impaired superficial sensitivity on the face (nucl. tractus spinalis n. Trigemini) on same side as that of the lesion.

5.    Alternating dissociatied hemianesthesia (lesion in fibers of spinothalamic pathway) on the opposite side.

Lesion in the reticular formation of the brain

1.    Disturbed sleep and wakefulness - Narcolepsy (bouts of sleepiness);

2.    Cataplexy (paroxysmal muscular hypotonia).

3.    Respiratory and cardiac failure.

 

Contents                        Previous page                     Next page

© 2003-2019 Moscow     Pain Clinic

Any reproduction of materials without wrtitten permission of the owner is Prohibited!

Рейтинг@Mail.ru

Webmaster and administrator - Aleksandr Nesterov, newnestor@mail.ru Translator - Neha Meher

Back to content