[Partial nuclear oculomotor nerve palsy, MLF syndrome, hallucinose pédonculaire due to midbrain infarction--a case report].
The authors report on a 62-year-old woman who suffered from partial nuclear oculomotor nerve palsy and the medial longitudinal fasciculus (MLF) syndrome caused by midbrain infarction. The lesion was confirmed to be in the mesencephalic tegmentum by axial sections acquired by magnetic resonance imaging (MRI). The lesion was located in the caudal region of the mesencephalic tegmentum by the sagittal MRI sections, and showed low signal intensity in T1-weighted images and high signal intensity in T2-weighted images. The patient exhibited bilateral ptosis due to the disturbance of caudal central nucleus and the supra-oculomotor area on both sides innervating the levator muscles of the upper eyelid. She also showed bilateral limitation of ocular adduction and supraduction; mild infraduction of the left eyeball; left monocular nystagmus; and disturbance of convergence, indicating partial involvement of the lateral somatic cell column innervating the muscles of the eyeball, the rostral interstitial nucleus of the medial longitudinal fasciculus (riMLF) and the MLF. Furthermore, transient visual hallucinations similar to hallucinose pédonculaire were confirmed. We are not aware of any reports describing simultaneous occurrence of bilateral ptosis, MLF syndrome, and transient visual hallucinations similar to hallucinose pédonculaire in the same patient.
Department of Neurology, Ohta Memorial Hospital.
K
K
Takamatsu
T
T
Takizawa
T
T
Miyamoto
T
T
Ohta
D002544:Cerebral Infarction / Q000150:complications*; D005260:Female; D006801:Humans; D008636:Mesencephalon / Q000098:blood supply*; D008875:Middle Aged; D019965:Neurocognitive Disorders / Q000209:etiology*; D015840:Oculomotor Nerve Diseases / Q000209:etiology*; D009886:Ophthalmoplegia / Q000209:etiology*; D013577:Syndrome