Inferior medial pontine syndrome
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Inferior medial pontine syndrome, also known as Foville syndrome, is one of the brainstem stroke syndromes occurring when there is infarction of the medial inferior aspect of the pons due to occlusion of the paramedian branches of the basilar artery 1-3. This infarction involves the following 1-3:
- corticospinal tract: contralateral hemiplegia/hemiparesis
- medial lemniscus: contralateral loss of proprioception and vibration
- middle cerebellar peduncle: ipsilateral ataxia
- facial nerve (CN VII) nucleus: ipsilateral facial weakness
- abducens nerve (CN VI) nucleus: lateral gaze paralysis and diplopia
The presentation can be variable but manifests usually as a gaze palsy to the side of the lesion, ipsilateral abducens, and ipsilateral facial palsy and contralateral hemiplegia may be present 1-3. Crossed hemihypesthesia and ipsilateral cerebellar signs may be present in the more complete form 1-3.
History and etymology
The syndrome was first described by Achille-Louis Foville (1799-1878), a French physician, in 1859 4.
- 1. Hubloue I, Laureys S, Michotte A. A rare case of diplopia: medial inferior pontine syndrome or Foville's syndrome. Eur J Emerg Med. 1997;3 (3): 194-8. Pubmed citation
- 2. Loeb C, Meyer JS. Pontine syndromes. In: Vinken PJ, Bruyn GW, eds. Handbook of clinical neurology. Amsterdam: North Holland Publishing Company, 1969:238-27 I
- 3. Allan Ropper, Joshua Klein, Martin Samuels. Adams and Victor's Principles of Neurology 10th Edition. (2014) ISBN: 9780071794794 - Google Books
- 4. Foville A. Note sur une paralysie peu connue de certain muscles de l'œil et sa liaison avec quelques points de l'anatomie et de la physiologie de la protubérance annulaire. Gaz. hebd. Sci. méd. 1895:746-50.