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Brissaud-Sicard syndrome is a very rare pontine stroke syndrome that involves the anterolateral and inferior pons.
Classically, the syndrome presents as ipsilateral facial cramps and contralateral hemiparesis 1-3.
It has been postulated that the syndrome is caused by damage to the pons involving the corticospinal tract and the CN VII nucleus or nerve root 2,3. It can be caused by a posterior circulation ischemic stroke, as well as other lesions such as neoplasm (e.g. brainstem glioma) 1-3.
Lesions are in the pons with imaging characteristics depending on underlying cause.
History and etymology
The syndrome is named after Édouard Brissaud (1852-1909) and Jean Athanase Sicard (1872-1929), French physicians, who described the syndrome in 1908 in patients with infarcts secondary to neurosyphilis 2,4. However, it was first described over fifty years earlier by Adolphe-Marie Gubler (1821-1879), another French physician, in 1856 2,5.
- 1. Marx JJ, Thömke F. Classical crossed brain stem syndromes: myth or reality?. (2009) Journal of neurology. 256 (6): 898-903. doi:10.1007/s00415-009-5037-2 - Pubmed
- 2. Tacik P, Krasnianski M, Alfieri A, Dressler D. Brissaud-Sicard syndrome caused by a diffuse brainstem glioma. A rare differential diagnosis of hemifacial spasm. (2014) Acta neurochirurgica. 156 (2): 429-30. doi:10.1007/s00701-013-1984-6 - Pubmed
- 3. Ertekin C, Celebisoy N, Colakoglu Z, Yünten N, Uludag B. Ipsilateral facial contracture due to pontine infarct. (1997) European neurology. 37 (1): 62-3. doi:10.1159/000117462 - Pubmed
- 4. Brissaud E, Sicard J. A L’hémispasme facial alterne. (1908) Le Presse médicale 16:234–236.
- 5. Gubler A. De l’Hémiplégie alterneen visage comme signe et lésion de la protuberance annulaire et comme preuve de la décussation des nerfs faciaux. (1856) Gazette hebdomadaire de medicine et de chirurgie 3:749–816, 789–792, 811–816