Neurocysticercosis presenting as Millard Gubler syndrome

Prasad, Rajniti; Kapoor, Kamal K.; Srivastava, Arvind; Op, Mishra

doi:10.4103/0976-3147.102634

Cited by 13 publications

(13 citation statements)

References 5 publications

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“…It is characterized by paralysis affecting the face and the abducent nerve on the side of the lesion and central hemiplegia on the opposite side[1]. It has been reported that MGS could be found in patients with brainstem tumor such as cavernous angioma[2-4], rimary meningeal hemangiopericytoma[5], neurocysticercosis[6]. As far as we know, only five cases of MGS caused by cerebral infarction have been reported[1,7-10].…”

Section: Introductionmentioning

confidence: 99%

Vertebrobasilar artery dissection manifesting as Millard-Gubler syndrome in a young ischemic stroke patient: A case report

Li¹,

Yuan²,

Hu³

2019

WJCC

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BACKGROUNDMillard-Gubler syndrome (MGS) is caused by a lesion in the brainstem at the level of the facial nerve nucleus, and it is also a rare ventral pontine syndrome. Vertebrobasilar artery dissection (VAD) is an uncommon cause of ischemic stroke. To the best of our knowledge, this is the first case report on the coexistence of MGS and VAD in a young acute ischemic stroke patient.CASE SUMMARYWe herein describe an unusual case of young acute ischemic stroke patient, presenting with acute right peripheral facial palsy, right abducens palsy, and contralateral hemihypesthesia, manifesting as MGS. After receiving dual antiplatelet therapy with aspirin and clopidogrel, as well as rosuvastatin, the patient recovered significantly. The high-resolution magnetic resonance imaging (MRI) indicated a diagnosis of VAD.CONCLUSIONOur finding further demonstrated that high-resolution MRI is a useful technique to early detect underlying dissection in posterior circulation ischemic stroke.

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Section: Introductionmentioning

confidence: 99%

Vertebrobasilar artery dissection manifesting as Millard-Gubler syndrome in a young ischemic stroke patient: A case report

Li¹,

Yuan²,

Hu³

2019

WJCC

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“…Less common presentations include encephalopathy, ataxia, sensory deficits, involuntary movements, stroke-like symptoms, isolated focal myokymia, and Millard-Gubler syndrome. 11,12 The neuroimaging findings of neurocysticerci vary with the stages of degeneration: namely, vesicular stage, colloidal vesicular stage, granular nodular stage, and nodular calcified stage.…”

Section: Discussionmentioning

confidence: 99%

Giant Cerebral Cysticercosis in an Infant Confused With a Thalamic Glioma

et al. 2014

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Neurocysticercosis is a common parasitic infection of the central nervous system. Intraparenchymal giant cysticercosis has been described in literature, but this is a rare report of a thalamic giant cysticercosis in a young child where the diagnosis could be made on follow-up. A 1½-year-old male child presented with seizures, hemiparesis, and features of raised intracranial pressure. Initial neuroimaging findings of thalamic swelling with minimal edema and contrast enhancement with choline peak on magnetic resonance spectroscopy were attributed to thalamic glioma. Subsequent imaging revealed a ring enhancing lesion with an eccentric nodule suggestive of neurocysticercosis. It later resolved with residual gliosis. The presence of a pathognomic scolex and the resolution of size and symptoms without definitive treatment helped in making the diagnosis. This report reinforces the importance of considering cysticercosis in diagnosis of acute presentations of large cerebral masses in infants, particularly in prevalent regions, and emphasizes the follow-up of these patients.

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“…At the level of the pons, Foville syndrome was frequently caused by hemorrhage (n = 8/15), followed by ischemic stroke (n = 4/15) and brain metastases (n = 2/15) [25][26][27][28][29][30][31][32][33][34][35][36][37]. Conversely, Millard-Gubler syndrome was mostly related to an ischemic stroke (n = 7/ 9), and rarely brought about by hemorrhage (n = 1/9) or brain abscess (n = 1/9) [38][39][40][41][42][43][44][45][46]. At the level of the medulla oblongata, Wallenberg syndrome was predominantly caused by ischemic stroke (n = 23/28), more rarely by hemorrhage (n = 2/28) or multiple sclerosis (n = 1/28) [18,.…”

Section: Causes Of Crossed Brainstem Syndromesmentioning

confidence: 99%

Crossed brainstem syndrome revealing bleeding brainstem cavernous malformation: an illustrative case

Beucler

Boissonneau

Ruf³

et al. 2021

BMC Neurol

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Background Since the nineteenth century, a great variety of crossed brainstem syndromes (CBS) have been described in the medical literature. A CBS typically combines ipsilateral cranial nerves deficits to contralateral long tracts involvement such as hemiparesis or hemianesthesia. Classical CBS seem in fact not to be so clear-cut entities with up to 20% of patients showing different or unnamed combinations of crossed symptoms. In terms of etiologies, acute brainstem infarction predominates but CBS secondary to hemorrhage, neoplasm, abscess, and demyelination have been described. The aim of this study was to assess the proportion of CBS caused by a bleeding episode arising from a brainstem cavernous malformation (BCM) reported in the literature. Case presentation We present the case of a typical Foville syndrome in a 65-year-old man that was caused by a pontine BCM with extralesional bleeding. Following the first bleeding episode, a conservative management was decided but the patient had eventually to be operated on soon after the second bleeding event. Discussion A literature review was conducted focusing on the five most common CBS (Benedikt, Weber, Foville, Millard-Gubler, Wallenberg) on Medline database from inception to 2020. According to the literature, hemorrhagic BCM account for approximately 7 % of CBS. Microsurgical excision may be indicated after the second bleeding episode but needs to be carefully weighted up against the risks of the surgical procedure and openly discussed with the patient. Conclusions In the setting of a CBS, neuroimaging work-up may not infrequently reveal a BCM requiring complex multidisciplinary team management including neurosurgical advice.

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Neurocysticercosis presenting as Millard Gubler syndrome

Cited by 13 publications

References 5 publications

Vertebrobasilar artery dissection manifesting as Millard-Gubler syndrome in a young ischemic stroke patient: A case report

Vertebrobasilar artery dissection manifesting as Millard-Gubler syndrome in a young ischemic stroke patient: A case report

Giant Cerebral Cysticercosis in an Infant Confused With a Thalamic Glioma

Crossed brainstem syndrome revealing bleeding brainstem cavernous malformation: an illustrative case

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