Benedikt syndrome

Case contributed by Dr Ammar Haouimi

Presentation

Right ptosis with crossed hemiataxia.

Patient Data

Age: 75 years
Gender: Male

Right paramedian midbrain area of high signal on T2 and FLAIR with restricted diffusion involving the presumed location of the red nucleus and fascicles of the oculomotor nerve keeping with an acute stroke.

Cerebral volume loss with small vessel ischemic changes and partially empty sella.

Case Discussion

The clinical presentation and the MRI features are most consistent with Benedikt syndrome.

Benedikt syndrome is defined as a midbrain stroke that involves the fascicles of the oculomotor nerve and the red nucleus with as a result an ipsilateral CN III palsy and crossed hemiataxia and choreoathetosis.

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