Facial colliculus syndrome

Last revised by Mohamed Saber on 29 Apr 2024

Facial colliculus syndrome refers to a constellation of neurological signs due to a lesion at the facial colliculus, involving:

Note that all symptoms are not invariably present in every patient.

Causes of facial colliculus syndrome vary by age:

The facial palsy is due to interruption of the ipsilateral facial nerve fibers at the genu as they arch behind the abducens nerve (CN VI) nucleus (thus forming the colliculus).

The conjugate gaze palsy is due to involvement of innervation not only to the ipsilateral abducens nerve to lateral rectus but also to the interneurons projecting into the medial longitudinal fasciculus which contribute innervation of the contralateral medial rectus (thus internuclear ophthalmoplegia). However, this is not always the case.

Usually only detected on MRI as a small focus of high signal in facial colliculus at the floor of 4th ventricle on DWI or T2/FLAIR  sequences. 

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