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.
  • Mild dilatation of the ventricular system with peri-ventricular T2/FLAIR hyperintensity.
  • Multiple bilateral cereberal demyelinating foci with high T2/FLAIR signal intensity are seen with no restricted diffusion.
  • Widened extra-axial CSF spaces.
  • Normal sellar region.
  • Normal cerebellum and cervico-medullary junction.

Case Discussion

This case shows typical right medial inferior pontine acute infarction; consistent with medial inferior 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 tegementum 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
Case created: 6th Jul 2014
Last edited: 16th Dec 2016
Inclusion in quiz mode: Included

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