- Ipsilateral tongue paralysis
Ipsilateral tongue atrophy - Contralateral spastic hemiplegia
a12h
- Hypoglossal nerve
- CST
- Ipsilateral tongue paralysis
Ipsilateral tongue atrophy - Contralateral spastic hemiplegia
- Contralateral body prop/2pt/vibration
a12h + ML
- Hypoglossal nerve
- CST
e. ML
- Ipsilateral paralysis of lateral gaze and/or internal strabismus
- Contralateral spastic hemiplegia
a6h
- Abducens nerve
- CST
- Ipsilateral paralysis of lateral gaze and/or internal strabismus
- Contralateral spastic hemiplegia
- Bell’s Palsy (sundown)
Millard Gubler - a6h + 7
- Abducens nerve
- CST
- Facial nerve
- Ipsilateral paralysis of lateral gaze and/or internal strabismus
- Contralateral loss of proprioception/2pt/vibration
- Uncoordinated horizontal gaze
- ??Ipsilateral CN nuclei»_space; Uvula deviation to normal side, tongue deviation ot lesioned side
- Contralateral spastic hemiplegia
a6h + ML (Syndrome of Foville)
- Abducens nerve
- ML
- MLF –> INO (CN6 and 3)
- CBT - crossed (ipsilateral)
- CST
- ipsilateral loss of sensation to face and scalp, ipsilateral paralysis of muscles of mastication
- contralateral spastic hemiplegia
a5h
- trigeminal (V1) nerve
- CST
crossed CBT - ipsilateral or contralateral?
level or decussation?
ipsilateral
medulla
areas of uncrossed CBT?
midbrain and pons
nuclei involved in CBT
nucleus ambiguus - uvula deviates toward normal
hypoglossal nuclei - tongue deviates toward lesion
INO
R nucleus of CN6 contracts ___ LR»_space; simulates __ nucleus of CN3 via __MLF
MLF,
Right nucleus of CN6 contracts Right LRmuscle»_space; simulates Left nucleus of CN3 (left MRmuscle) via Left MLF
- ipsilateral loss of sensation to face and scalp, ipsilateral paralysis of muscles of mastication
- contralateral spastic hemiplegia
- ??Contralateral CN nuclei»_space; supranuclear facial palsy, hypoglossal nucleus, nucelus ambiguus, abducens nucelus
a5h and Dorsal extension
- Triennial nerve
- ML
- uncrossed CBF
- ipsilateral external strabismus, pupil dilation, complete ptosis
- contralateral spastic hemiplegia
- contralateral resting tremor
- supranuclear facial palsy
a3h (Weber’s Syndrome)
- occulomotor nerve
- CST
- Substantia nigra
- uncrossed CBT
- Dysarthria, dysphagia, uvula deviation to normal side
- loss of body contralateral pain/temp
sometimes: contralateral loss of 2pt/prop and loss of gag reflex+ipsilatereal anesthesia of palate/pharynx
Lesion of Nucleus Ambigus + SL
- Nucelus ambiguus
- ML
- sometimes - ML + solitary nucleus
Name for:
- loss of contralateral pain/temp
- loss of ipsilateral pain/temp from 1/2 of face
alternating hemianalgesia
alternating hemianalgesia
Wallenberg Syndrome = Lateral MEdullary Syndrome
PICA
Deaf
Bell’s palsy
Alternating hemianalgesia
intention tremors
Cerebellopontine Angle syndrome
what is the cause of cerebellopontine syndrome?
Tumor of posterior fossa = comrpesses pons, cerebellum, medulla
- External strabismus, pupillary dilation, complete ptosis
- Contralateral loss of proprioception/2pt
- intention tremor/spasticity, ataxia, etc.
Benedikt’s Syndrome (leision of midbrain tegmentum)
- CN3
- ML
- Red nuc/seperior cerebellar peducncles/midbrain tegmentum
paralysis of upward gaze caused by what and what structure is affected
Parinaud Syndrome -
superior colliculus compressed by pineal tumor or varix of Great Vein of Galen
behavioral changes, crawling ant sensation
Thalamic Syndrome
