Question

A 62-year-old patient presents with left-sided arm and leg weakness, right-sided facial paralysis, and difficulty with horizontal eye movements. Based on the clinical presentation, which of the following syndromes is most consistent with these symptoms?

• A. Foville syndrome
• B. Benedict’s syndrome
• C. Millard-Gubler syndrome
• D. Wallenberg syndrome

Hint:

In patients with a combination of facial paralysis, hemiparesis, and eye movement difficulties, think of Millard-Gubler syndrome and consider a lesion in the pons.

Answer 1

The Correct Option is C

Millard-Gubler syndrome is a condition that arises from a lesion in the pons, specifically affecting the lower portion. It is characterized by contralateral hemiparesis (in this case, left-sided arm and leg weakness) and ipsilateral facial paralysis (right-sided facial paralysis). Additionally, difficulty with horizontal eye movements is a hallmark of pontine lesions affecting the abducens nerve (which controls lateral eye movement). This combination of findings points directly to Millard-Gubler syndrome. - Foville syndrome also involves a pontine lesion, but it is more commonly associated with other cranial nerve deficits and contralateral hemiplegia. - Benedict’s syndrome involves a lesion in the midbrain and typically presents with oculomotor palsy, which is not consistent with the symptoms here. - Wallenberg syndrome typically presents with symptoms like vertigo, dysphagia, and hoarseness, but it does not cause the specific combination of facial paralysis, arm/leg weakness, and horizontal eye movement issues seen in this patient.