Caudal paramedian midbrain syndrome

Mossuto-Agatiello, Luigi

doi:10.1212/01.wnl.0000218180.03127.11

Cited by 43 publications

(15 citation statements)

References 9 publications

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“…Notwithstanding the small amount of the infarction, such strategic location may have damaged both the right and the left cerebellar-thalamic fibers, thus causing the gait and bilateral limb ataxia. Differently from the cases previously reported [1][2][3][4][5][6], in our patient the infarct was not lateralized and was located in the central portion of the midbrain, explaining the severity of the cerebellar manifestation. …”

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confidence: 99%

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Gait and bilateral limb ataxia as isolated feature of a lower midbrain tegmental infarction

et al. 2008

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confidence: 99%

“…A tetra-ataxia has been reported in patients with midbrain infarction [1][2][3][4][5][6] but in none of them it was the isolated feature. In these cases the bilateral ataxia was associated to other neurological deficits, such as hemiparesis, dysphagia, dysphonia, eye-movement disorders or palatal myoclonus.…”

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confidence: 99%

Gait and bilateral limb ataxia as isolated feature of a lower midbrain tegmental infarction

et al. 2008

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“…Most of these nerve fibers decussate in the PM area of the caudal midbrain (fig. 3) (decussation of the superior cerebellar peduncle) [17], and ended in the red nucleus (cerebellorubral tract). The remaining fibers ascend at the lateral area of the substantia nigra and project directly to the ventral lateral nucleus of the thalamus (cerebellothalamic tract).…”

Section: Discussionmentioning

confidence: 99%

Clinical Study of Twenty-One Patients with Pure Midbrain Infarction

et al. 2011

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We investigated the neurological and MRI findings of 21 patients with pure midbrain infarction. The locations of the infarcts were classified into paramedian (PM) area (13 patients), lateral area (6 patients), and PM and lateral areas (1 patient), based on the distribution of each penetrating artery of the midbrain. The infarction of 1 patient showed bilateral multiple lesions. In the PM area group, 12 patients showed eye movement disorders and truncal and gait ataxia. Eye movement disorders consisted of medial longitudinal fasciculus syndrome, oculomotor nerve palsy, and bilateral vertical gaze palsy. The infarcts of the 2 patients with bilateral vertical gaze palsy were located in the PM area on both sides. Eye movement disorders and truncal and gait ataxia were prominent in the PM area group. Ataxic hemiparesis was shown in 2 patients of the PM area group and 4 patients of the lateral area group. We showed that ataxic hemiparesis also occurred in PM area infarction, although ataxic hemiparesis was a prominent feature of lateral area infarction.

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“…MossutoAgatiello (7) reported five patients with unilateral lower midbrain infarction of the decussation of the brachium conjunctivum (caudal paramedian midbrain syndrome). Bilateral ataxia, prevalent on one side, was the most characteristic and most constant clinical feature, while eye movement disorders were nonspecific (7).…”

Section: Discussionmentioning

confidence: 99%

Midbrain Infarction Causing Oculomotor Nerve Palsy and Ipsilateral Cerebellar Ataxia

et al. 2014

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We herein report the case of an 81-year-old woman with midbrain infarction causing pupil-sparing oculomotor nerve palsy with ipsilateral cerebellar ataxia. The lesion was located at the rostral end of the decussation of the superior cerebellar peduncle touching the dorsal side, further caudal and dorsal to causal lesions of Claude's syndrome, which presented as oculomotor palsy and contralateral cerebellar ataxia. This is the third report of midbrain infarction causing partial oculomotor nerve palsy with ipsilateral cerebellar ataxia. It may be possible to establish this entity as a new syndrome following the accumulation of more cases.

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Caudal paramedian midbrain syndrome

Abstract: A single strategically placed unilateral lesion can cause bilateral dysfunction. In addition, a bilateral cerebellar syndrome can occur with unilateral lesions in the lower midbrain with a wide range of other clinical features.

Cited by 43 publications

References 9 publications

Gait and bilateral limb ataxia as isolated feature of a lower midbrain tegmental infarction

Gait and bilateral limb ataxia as isolated feature of a lower midbrain tegmental infarction

Clinical Study of Twenty-One Patients with Pure Midbrain Infarction

Midbrain Infarction Causing Oculomotor Nerve Palsy and Ipsilateral Cerebellar Ataxia

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