scholarly journals Isolated abducens nucleus syndrome due to pontine tegmentum infarction

2021 ◽  
Vol 11 (5) ◽  
pp. 135-137
Author(s):  
Mohamed Hamid ◽  
Youssouf Benmoh ◽  
Kadira Adan ◽  
Houda Alloussi ◽  
Cedrick Moussavou ◽  
...  
Keyword(s):  
Eye Movement ◽  
Facial Palsy ◽  
Brain Mri ◽  
Small Lesion ◽  
Abducens Nucleus ◽  
Ischemic Lesion ◽  
Peripheral Facial Palsy ◽  
Pontine Tegmentum ◽  
Horizontal Gaze ◽  
Gaze Palsy

Introduction: Abnormalities of horizontal gaze could be caused by damage of the abducens nucleus due to ischemic lesion. We report a patient with isolated horizontal gaze palsy as a result of a small ischemic lesion of the pontine tegmentum. Observation: A 61-year-old man, with medical history of diabetes mellitus, dyslipidemia and high blood pressure, was hospitalized after 12 hours of transient dizziness and diplopia. On examination, he had conjugate eye deviation to the right side with horizontal gaze paralysis toward controlateral side. Vertical eye movements, convergence and pupillary reflex were preserved with no peripheral facial palsy. Brain MRI revealed a small lesion in the left pontine tegmentum. Patient received aspirin with atorvastatin and the gaze palsy has been disappeared three weeks later. Discussion: Conjugate lateral eye movement paralysis is commonly attributed to lesions of the caudal pons involving the abducens nucleus. horizontal gaze palsy is often associated to an ipsilateral peripheral facial palsy. In our case, the left lateral gaze palsy was isolated. The pontine lesion should be strictly confined the abducens nucleus which is extremely rare. the outcome of eye movement deviation in brainstem lesions is favorable within few weeks. Conclusion: Our case provides evidence that small pontine lesions can damage the abducens nerve nucleus without causing ipsilateral peripheral facial palsy.

scholarly journals Bilateral facial colliculus syndrome caused by pontine tegmentum infarction: a case report

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sheng Zhuang ◽  
Weiye Xie ◽  
Chengjie Mao
Keyword(s):  
Patent Foramen Ovale ◽  
Demyelinating Disease ◽  
Sudden Onset ◽  
Foramen Ovale ◽  
Peripheral Facial Palsy ◽  
Csf Analysis ◽  
Pontine Tegmentum ◽  
Rare Manifestation ◽  
Horizontal Gaze ◽  
Gaze Palsy

Abstract Background Bilateral facial colliculus syndrome is a rare clinical presentation in patient with pontine infarction. We herein described a case of bilateral facial paralysis and complete horizontal gaze palsy possibly caused by paradoxical embolization from patent foramen ovale related stroke. Case presentation A 55-year-old male presented with sudden onset of complete peripheral facial palsy and horizontal gaze palsy after Valsava maneuver. MRI revealed symmetric involvement of bilateral pontine tegmentum in accordance with the location of facial colliculus. CSF analysis and follow-up MRI showed no evidence of central demyelinating disease. Subsequent echocardiography revealed patent foramen ovale and closure surgery was performed. Conclusions Facial colliculus syndrome with symmetric dorsal pontine tegmentum involvement may a rare manifestation in posterior circulation stroke.

scholarly journals Absence of REM Sleep, Altered NREM Sleep and Supranuclear Horizontal Gaze Palsy Caused by a Lesion of the Pontine Tegmentum

SLEEP ◽  
1993 ◽  
Vol 16 (2) ◽  
pp. 184-188 ◽  
Author(s):  
Francesc Valldeoriola ◽  
Joan Santamaria ◽  
Francesc Graus ◽  
Eduardo Tolosa
Keyword(s):  
Rem Sleep ◽  
Nrem Sleep ◽  
Pontine Tegmentum ◽  
Horizontal Gaze ◽  
Gaze Palsy

Bilateral Horizontal Gaze Palsy with Unilateral Peripheral Facial Paralysis Caused by Pontine Tegmentum Infarction

2009 ◽  
Vol 18 (3) ◽  
pp. 244-246 ◽  
Author(s):  
Andre C. Felicio ◽  
Denis B. Bichuetti ◽  
Luis F. Marin ◽  
William A.C. dos Santos ◽  
Clecio Godeiro-Junior
Keyword(s):  
Facial Paralysis ◽  
Peripheral Facial Paralysis ◽  
Pontine Tegmentum ◽  
Horizontal Gaze ◽  
Gaze Palsy

scholarly journals Brain MRI Features in Horizontal Gaze Palsy with Progressive Scoliosis

2017 ◽  
Vol 02 (01) ◽  
Author(s):  
Mostafa Almasi ◽  
Mohammad Rohani ◽  
Mostafa Soltan Sanjari ◽  
Atefeh Imani
Keyword(s):  
Brain Mri ◽  
Progressive Scoliosis ◽  
Mri Features ◽  
Horizontal Gaze ◽  
Gaze Palsy

scholarly journals Bilateral horizontal gaze palsy in an 8-year-old girl; a rare case with NDUFS4 gene mutation: a case report and literature review

2019 ◽  
Author(s):  
Mohammad Vafaee-Shahi ◽  
Saeide Ghasemi ◽  
Mehran Beiraghi Toosi ◽  
Mahmoud Reza Ashrafi ◽  
Reza Shervin Badv ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Gene Mutation ◽  
Genetic Test ◽  
Neurodegenerative Disorder ◽  
Brain Mri ◽  
Clinical Signs ◽  
Leigh Syndrome ◽  
Resonance Spectroscopy ◽  
Horizontal Gaze ◽  
Gaze Palsy

Abstract Background: Leigh syndrome (LS) is a rare and inherited disease which is associated with progressive neurological disorders. The molecular underlying mechanism in LS is defined with some defects in mitochondrial respiratory chain enzymes. Case presentation: Here, an 8-year-old girl is reported with bilateral horizontal gaze palsy, ataxia and drowsiness. She developed unsteady gait, drowsiness, progressive ataxia and intention tremor during her admission period. The laboratory tests were reported within normal values including biochemical, hematological, immunological, infectious and inflammatory markers and blood and cerebrospinal fluid (CSF) lactate. Brain magnetic resonance imaging (MRI) demonstrated dorsal midbrain, bilateral putamen nuclei and cerebellar dentate nucleus involvement. Ocular examination revealed retinal atrophy and pale disk in both sides. These symptoms were in favor of a neurodegenerative disorder. Magnetic resonance spectroscopy (MRS) revealed an elevated lactate peak in involved areas which suggested a mitochondrial disease. Finally, the molecular genetic test reported NDUFS4 gene mutation which confirmed the presence of Leigh syndrome. She responded significantly to mitochondrial treatment cocktail and clinical signs and symptoms improved gradually. NDFUS4 gene encodes a subunit of mitochondrial complex I (NADH: ubiquinone oxidoreductase) that removes electrons from NADH and transfers them to the electron acceptor ubiquinone. Conclusion: Our findings indicated that various symptoms and clinical features can be found in Leigh syndrome which could be probably due to different mutations in mitochondrial genes. Therefore, appropriate clinical and laboratory settings along with brain MRI, MRS and genetic test analysis would be necessary for the early diagnosis.

Isolated bilateral horizontal gaze palsy as first manifestation of multiple sclerosis

2014 ◽  
Vol 20 (6) ◽  
pp. 754-755 ◽  
Author(s):  
Stefan Kipfer ◽  
David W Crook
Keyword(s):  
Multiple Sclerosis ◽  
Brain Magnetic Resonance Imaging ◽  
Sudden Onset ◽  
Neurological Deficits ◽  
Medial Part ◽  
Blurred Vision ◽  
Initial Manifestation ◽  
Pontine Tegmentum ◽  
Horizontal Gaze ◽  
Gaze Palsy

Predilection sites for infratentorial multiple sclerosis lesions are well known and frequently involve the fasciculus longitudinalis medialis leading to classical internuclear ophthalmoplegia. We report a very rare oculomotor disorder due to a demyelinating central nervous system (CNS) lesion in the medial part of the lower pontine tegmentum. A 36-year-old man presented with sudden onset of blurred vision. Clinically there was limited eye adduction and abduction to either side, which corresponds to bilateral horizontal gaze palsy. Brain magnetic resonance imaging (MRI) showed a demyelinating CNS lesion affecting the fasciculus longitudinalis medialis, abducens nuclei or abducens fibres in the medial part of the lower pontine tegmentum. Furthermore there were six further demyelinating white matter lesions fulfilling all Barkhof criteria for multiple sclerosis. Demyelinating CNS lesions causing isolated bilateral horizontal gaze palsy are exceptional and usually associated with further focal neurological deficits, which was not the case in the presenting patient. This is a unique video report of isolated bilateral horizontal gaze palsy as the initial manifestation of demyelinating CNS disease, which lead to definite diagnosis of relapsing remitting multiple sclerosis.

Horizontal Gaze Palsy and Rapidly Progressive Scoliosis: Typical Findings in ROBO3 Mutations

2014 ◽  
Vol 45 (S 01) ◽  
Author(s):  
J. Koch ◽  
F. Landauer ◽  
T. Keindl ◽  
M. Sloman
Keyword(s):  
Progressive Scoliosis ◽  
Horizontal Gaze ◽  
Gaze Palsy
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