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Inferior medial pontine (Foville) syndrome

Case contributed by Dr Mohammad A. ElBeialy

Presentation

Left-sided weakness, diplopia and right-sided facial palsy.

Patient Data

Age: 65 years
Gender: Male

The right medial inferior pons shows a wedge-shaped area of restricted diffusion with high DWI and low ADC signal. It shows low T1 and high T2 / FLAIR signal intensity as well as subtle T1 hypointensity.

Multiple bilateral cerebral demyelinating foci with high T2/FLAIR signal intensity are seen with no restricted diffusion.

Mild dilatation of the ventricular system with peri-ventricular T2/FLAIR hyperintensity.

Widened extra-axial CSF spaces.

Normal sellar region. Normal cerebellum and cervico-medullary junction.

Case Discussion

This case shows typical right inferior medial pontine acute infarction; consistent with inferior medial pontine (Foville) syndrome. Atrophic brain changes with peri-ventricular arteriosclerotic leukoencephalopathy and bilateral cerebral small chronic vessel disease.

Inferior medial pontine (Foville) syndrome is characterized by:

  • contralateral hemiparesis or hemiplegia due to corticospinal tract affection within the dorsal tegmentum of the pons at its inferior third.
  • peripheral ipsilateral facial nerve palsy.
  • conjugate gaze palsy with inability to look to the side of the lesion with diplopia.

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Case information

rID: 29951
Published: 7th Jul 2014
Last edited: 4th Dec 2019
Inclusion in quiz mode: Included

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