Cerebellar and brainstem syndromes- definitions

Question 1

Ataxia of gait or torso, dysarthrai, nystagmus, nausea

Answer 1

Medial cerebellar syndrome

Question 2

Ataxia, dysmetria, intention tremor of ipsilateral limbs, dysarthria, vertigo, nystagmus, nausea

Answer 2

Lateral cerebellar syndrome

Question 3

LMN abnormalities of ipsilateral sternocleinomastoid and trapezius muscles

Answer 3

Accessory neuropathy

Question 4

Deviation of protruded tongue toward weak side, dysarthria due to inability to enunciate lingual sounds (la)

Answer 4

Hypoglossal neuropathy

Question 5

Dysarthria of pharyngeal consonants (ka, ha), dysphonia, dysphagia, nasal regurgitation, ipsilateral weakness of palate elevation, diminished ipsilateral efferent limb of pharyngeal reflex

Answer 5

Vagus neuropathy

Question 6

Ipsilateral afferent limb dysfunction of gag reflex, LMN abnormalities of stylopharyngeus muscle
Rarely, parasympathetic, viscerosensory, taste abnormalities

Answer 6

Glossopharyngeal neuropathy

Question 7

Conductive or sensorineural hearing loss, vertigo, nausea, nystagmus

Answer 7

Vestibulocochlear neuropathy

Question 8

Sound louder in ipsilateral ear with Webers and louder on mastoid for Rhinnes

Answer 8

Conductive hearing loss

Question 9

Sound louder in contralateral ear for Webers and louder near ear than mastoid for Rhinne’s

Answer 9

Sensorineural hearing loss

Question 10

Ipsilateral hyperacusis, abnormal taste
Ipsilateral LMN abnormalities of upper and lower face
Ipsilateral decreased lacrimation and salivation

Answer 10

Facial neuropathy

Question 11

In facial neuropathy, the ipsilateral hyperacusis is due to involvement of the ______

Answer 11

Stapedius

Question 12

In facial neuropathy, the abnormal taste is due to involvement of the _____

Answer 12

Solitary nucleus

Question 13

In facial neuropathy, the decrease in lacrimation and salivation is due to involvement of the _______

Answer 13

parasympathetics to glands

Question 14

Somatosensory abnormalities of face, hyperacusis

LMN abnormalities of muscles of mastication

Answer 14

Trigeminal neuropathy

Question 15

In trigeminal neuropathy, the hyperacusis is due to involvement of the ________

Answer 15

tensor tympany

Question 16

Horizontal diplopia due to weakness of lateral rectus, worse with gaze in the direction of the weak muscle
Abnormal eye is unable to abudct

Answer 16

Abducens neuropathy

Question 17

Ipsilateral weakness of eye depression when adducted and intorsion when abducted
Patients flex neck anteriorly and contralaterally to improve diplopia

Answer 17

Trochlear neuropathy

Question 18

Ipsilateral ptosis, weakness of eye elevation and adduction

Aniscoria worse in light

Answer 18

Oculomotor neuropathy

Question 19

Ipsilateral ptosis
Aniscoria worse in dark
Anhidrosis

Answer 19

Horner’s syndrome

Question 20

Differentiate ptosis in Horner’s syndrome vs oculomotor neuropathy

Answer 20

Oculomotor neuropathy- levator palpebrae

Horner’s syndrome- superior tarsal muscle

Question 21

Position, vibration, fine touch abnormalities in contralateral body
Pain, temp, gross touch abnormalities in contralateral face
LMN abnormalities of the ipsilateral tongue
UMN abnormalities of contralateral body

Answer 21

Medial medullary syndrome

Question 22

In medial medullary syndrome, the position/ vibration/ fine touch abnormalities in the contralateral body are due to involvement of the _________

Answer 22

medial lemniscus

Question 23

In medial medullary syndrome, the pain, temp, gross touch abnormalities in contralateral face are due to involvement of the __________

Answer 23

trigeminothalamic tract

Question 24

In medial medullary syndrome, the LMN abnormalities of the ipsilateral tongue are due to involvement of the _______

Answer 24

hypoglossal nucleus

Question 25

In medial medullary syndrome the UMN abnormalities of the contralateral body are due to involvement of the _____

Answer 25

pyramid

Question 26

Diminished pain, temp, gross touch for ipsilateral face Diminished pain, temp, cross touch for contralateral body (spinothalamic) Diminished ipsilateral taste (solitary nucleus) Vergtigo, nausea, nystagmus (vestibular nuclei) Ipsilateral sensorineural hearing loss (cochlear nuclei) Diminished ipsilateral afferent limb function of the pharyngeal reflex (spinal trigeminal nucleus) Diminished ipsilateral palate elevation, dysarthria, dysphagia, dysphonia, diminished ipsilateral efferent limb of gag reflex (ambiguus nucleus) Ipsilateral limb ataxia (inferior cerebellar peduncle) Ipsilateral Horner's syndrome Usually caused by posterior inferior cerebellar artery dysfunction

Answer 26

Lateral medullary syndrome

Question 27

In lateral medullary syndrome, the diminished pain, temp, gross touch for ipsilateral face is due to involvement of _____

Answer 27

spinal trigeminal nucleus

Question 28

In lateral medullary syndrome, the diminished pain, temp, gross touch for contralateral body is due to involvement of the _______

Answer 28

spinothalamic tract

Question 29

Position, vibration, fine touch abnormalities of contralateral body Somatosensory abnormalities of contralateral face ``` UMN abnormalities of contralateral body Limb ataxia Ipsilateral eye abduction weakness Ipsilateral horizontal gaze paresis Ipsilateral opthalmoparesis Weakness of ipsilateral face Contralateral lower facial weakness ```

Answer 29

Medial pontine syndrome

Question 30

In medial pontine syndrome, the position, vibration, fine touch abnormalities of contralateral body are due to involvement of ______

Answer 30

medial lemniscus

Question 31

In medial pontine syndrome, the somatosensory abnormalities of contralateral face are due to involvement of the ______

Answer 31

trigeminothalamic tract

Question 32

In medial pontine syndrome, the UMN abnormalities of contralateral body are due to involvement of the ______

Answer 32

corticospinal tract

Question 33

In medial pontine syndrome, the limb ataxia is due to involvement of ______

Answer 33

corticopontine tract

Question 34

In medial pontine syndrome the ipsilateral eye abduction weakness is due to involvement of _______

Answer 34

abducens nucleus

Question 35

In medial pontine syndrome, the ipsilateral opthalmoparesis is due to involvement of _____

Answer 35

medial longitudinal fasciculus

Question 36

In medial pontine syndrome, the weakness of ipsilateral face is due to involvement of _____

Answer 36

facial nucleus

Question 37

In medial pontine syndrome, the contralateral lower facial weakness is due to involvement of

Answer 37

corticobulbar tract

Question 38

Pain, temperature, gross touch abnormalities of contralateral body Somatosensory abnormalities of ipsilateral face and ipsilateral afferent limb dysfunction of corneal reflex Ipsilateral hyperacusis Ipsilateral hearing loss, vertigo, nausea, nystagmus ipsilateral upper and lower facial weakness and efferent limb dysfunction of corneal reflex LMN abnormalities of ipsilateral muscles of mastication Ipsilateral limb ataxia Ipsilateral Horner's syndrome

Answer 38

Lateral pontine syndrome

Question 39

In lateral pontine syndrome, the ipsilateral limb ataxia is due to involvement of _____

Answer 39

pontocerebellar tract

Question 40

In lateral pontine syndrome, the LMN abnormalities of ipsilateral muscles of mastication is due to involvement of _____

Answer 40

trigeminal nucleus

Question 41

In lateral pontine syndrome, the ipsilateral upper and lower and upper facial weakness and the dysfunction of corneal reflex are due to involvement of _____

Answer 41

facial nucleus

Question 42

In lateral pontine syndrome, the pain/ temp/ gross touch abnormalities in the contralateral body is due to involvement of _____

Answer 42

spinothalamic tract

Question 43

In lateral pontine syndrome, the somatosensory abnormalities of ipsilateral face and ipsilateral afferent limb dysfunction of corneal reflex is due to involvement of _____

Answer 43

trigeminal nucleus

Question 44

In lateral pontine syndrome, the hyperacusis is due to involvement of _____

Answer 44

facial and trigeminal nuclei

Question 45

In lateral pontine syndrome, the ipsilateral hearing loss, vertigo, nausea, nystagmus is due to involvement of ______

Answer 45

vestibular or cochlear nuclei

Question 46

Loss of most voluntary motor functions, may have control of eyelid elevation

Answer 46

Locked in syndrome | bilateral lesion of basis pontis sparing tegmentum

Question 47

UMN abnormalities of contralateral arm, leg, lower face Ptosis, dysconjugacy Contralateral trochlear neuropathy Contralateral limb ataxia Dysfunction of ipsilateral efferent limb of pupillary light reflex

Answer 47

Medial midbrain syndrome

Question 48

In medial midbrain syndrome, the UMN abnormalities of the contralateral arm, leg, and lower face are due to involvement of _________

Answer 48

corticospinal and corticobulbar tracts

Question 49

In medial midbrain syndrome, the ptosis and dysconjugacy are due to involvement of _______

Answer 49

oculomotor nucleus

Question 50

In medial midbrain syndrome, the contralateral trochlear neuropathy is due to involvement of the _____

Answer 50

trochlear nucleus

Question 51

In medial midbrain syndrome the contralateral limb ataxia is due to involvement of the _______

Answer 51

corticopontine tract

Question 52

In medial midbrain syndrome the dysfunction of the ipsilateral efferent limb of the pupillary reflex is due to involvement of the _________

Answer 52

EW nucleus

Question 53

Somatosensory abnormalities of contralateral face, arm, leg UMN abnormalities of contralatreral leg, arm, face Contralateral limb ataxia Horner's syndrome

Answer 53

Lateral midbrain syndrome

Question 54

In lateral midbrain syndrome, the somatosensory abnormalities of the contralateral face, arm, and leg are due to involvement of ______

Answer 54

trigeminothalamic, spinothalamic, medial lemniscus

Question 55

In lateral midbrain syndrome the UMN abnormalities of the contralateral arm, leg, and face are due to involvement of the ______

Answer 55

corticospinal and corticobulbar tracts

Question 56

In lateral midbrain syndrome the contralateral limb ataxia is due to involvement of ______

Answer 56

corticopontine tract

Question 57

Monocular visual loss | Afferent pupillary defect

Answer 57

Retinopathy, optic neuropathy

Question 58

Lesion of medial optic chiasm

Answer 58

Bitemporal hemianopsia