Question 1721
{"accessible":true,"alternatives":[{"id":8551,"text":"Upward gaze palsy, often manifesting as diplopia, pupillary light-near dissociation (pupils respond to near stimuli, but not light) and convergence-retraction nystagmus."},{"id":8552,"text":"Lower motor neuron facial nerve palsy including loss of sensation of the taste in anterior two-thirds of the tongue and hyperacusis, diplopia and horizontal conjugate gaze palsy."},{"id":8553,"text":"Vestibulocerebellar symptoms, autonomic dysfunction, ipsilateral Horner syndrome and sensory symptoms pain over the ipsilateral face and loss of pain and temperature sensation over the contralateral side of body."},{"id":8554,"text":"Palatal myoclonus, rhythmic involuntary movement of the soft palate, uvula, pharynx, larynx and upper extremity."}],"archived":false,"correctAlternativeId":8552,"explanation":"\u003cp\u003eThis is infarct involves the facial colliculus which is formed by the fibers of the facial nerve passing behind the abducens cranial nerve nucleus before heading anterolaterally towards its exit at the pontomedullary junction. The medial longitudinal fasciculus (MLF) is located near the midline and may be involved.\u0026nbsp;\u003c/p\u003e\u003cp\u003eUpward gaze palsy, often manifesting as diplopia, pupillary light-near dissociation (pupils respond to near stimuli, but not light) and convergence-retraction nystagmus describes\u0026nbsp;\u003ca href=\"/articles/parinaud-syndrome\"\u003eParinaud syndrome\u003c/a\u003e.\u0026nbsp;\u003c/p\u003e\u003cp\u003eVestibulocerebellar symptoms (vertigo, falling towards the side of lesion, diplopia, and multidirectional nystagmus),\u0026nbsp;autonomic dysfunction,\u0026nbsp;ipsilateral Horner syndrome and\u003cbr\u003esensory symptoms pain over the ipsilateral face and loss of pain and temperature sensation over the contralateral side of body describes the\u0026nbsp;\u003ca href=\"/articles/lateral-medullary-syndrome\"\u003elateral medullary syndrome\u003c/a\u003e.\u003c/p\u003e\u003cp\u003ePalatal myoclonus, rhythmic involuntary movement of the soft palate, uvula, pharynx, larynx and upper extremity are classically described clinical features of\u0026nbsp;\u003ca href=\"/articles/hypertrophic-olivary-degeneration\"\u003ehypertrophic olivary degeneration\u003c/a\u003e.\u003c/p\u003e","id":1721,"imageUrl":"https://prod-images-static.radiopaedia.org/multiple_choice_questions/991/aaaa_big_gallery.jpeg","imageAttribution":{"kind":"case","rID":4187},"imageAttributionCaseInfo":{"title":"Sixth cranial nerve infarct","contributor_name":"Frank Gaillard","contributor_param":"frank","case_rid":4187,"case_param":"sixth-cranial-nerve-infarct"},"firstQuestionPath":"/questions/2590","nextQuestionPath":"/articles/brainstem-stroke-syndromes/questions/1719","relatedArticles":[{"id":13437,"title":"Ischemic stroke","link":"/articles/ischaemic-stroke?lang=us"},{"id":1085,"title":"Brain arterial vascular territories","link":"/articles/brain-arterial-vascular-territories?lang=us"}],"alsoUsedIn":[],"stem":"\u003cp\u003eAn infarct in this location would be expected to lead to which of the following clinical syndrome?\u003c/p\u003e","menuLinks":[{"text":"Report problem with question","url":"https://docs.google.com/forms/d/e/1FAIpQLSfO3soWYhOjJ7yErSysyCe5V4A1CqW7WK3rDA7MtAkecMGqNw/viewform?entry.1624461248\u0026entry.553583435=https://radiopaedia.org/questions/1721"}],"attemptsPercentages":[{"alternativeId":"8554","percentage":12},{"alternativeId":"8553","percentage":28},{"alternativeId":"8552","percentage":36},{"alternativeId":"8551","percentage":24}],"promptToLogin":false,"questionManager":false,"articleId":"brainstem-stroke-syndromes"}