Dorsal midbrain syndrome (Benedikts syndrome)

What is the dorsal midbrain syndrome? 

Dorsal midbrain syndrome results from a lesion in the midbrain tegmentum caused by occlusion of paramedian branches of the basilar or posterior cerebral arteries or both. Its signs are:

  • Ipsilateral oculomotor paresis, ptosis, and dilated pupil (damage to fascicle of cranial nerve III, including parasympathetic fibers as in Weber’s syndrome).
  • Contralateral involuntary movements, such as intention tremor, ataxia, and chorea (damage to red nucleus).
  • Contralateral hemiparesis may be present if the lesion extends ventrally.
  • Contralateral hemianesthesia may be present if the lesion extends laterally, affecting the spinothalamic tract and medial lemniscus.

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