Lateral pontine syndrome


Lateral pontine syndrome, also known as Marie-Foix syndrome or Marie-Foix-Alajouanine syndrome is one of the brainstem stroke syndromes of the lateral aspect of the pons. A lateral pontine syndrome is a lesion which is similar to the lateral medullary syndrome, but because it occurs in the pons, it also involves the cranial nerve nuclei of the pons.

History

Lateral pontine syndrome was first described in France by French neurologists Pierre Marie, Charles Foix, and Théophile Alajouanine in 1922. They were the first to identify and describe the symptoms and causes of this syndrome. In their original description, they reported findings from autopsies that showed spinal cord necrosis and multiple tortuous and thickened blood vessels on the surface of the spinal cord. This condition was later called necrotizing myelopathy.
They emphasized that in their two cases, no thrombosis was present. They considered the vascular component of the entity they reported to be a wall thickening, without luminal narrowing or obliteration of the cord vessels. They addressed, and ruled out, the possibility of vascular malformations.

Symptoms

Damage to the following areas produces symptoms :
Structure affectedEffect
Lateral spinothalamic tractContralateral loss of pain and temperature from the trunk and extremities.
Facial nucleus & facial Nerve ' Ipsilateral paralysis of the upper and lower face. ' Ipsilateral loss of lacrimation and reduced salivation. ' Ipsilateral loss of taste from the anterior two-thirds of the tongue. ' Loss of corneal reflex.
Principal sensory trigeminal nucleus and tractIpsilateral loss of all sensory modalities to the face
Vestibular Nuclei and intraaxial nerve fibersNystagmus, nausea, vomiting, and vertigo
Cochlear nuclei and intraaxial nerve fibersHearing loss - ipsilateral central deafness
Middle & inferior cerebellar peduncleIpsilateral limb and gait ataxia
Descending sympathetic tractIpsilateral Horner's syndrome

Causes

The syndrome occurs due to occlusion of perforating branches of the basilar and anterior inferior cerebellar arteries. It can also be caused by an interruption to the blood supply of the anterior inferior cerebellar artery or circumferential arteries.

Treatment

The treatment for lateral pontine syndrome varies greatly, so there are different medications for different symptoms. Sometimes blood thinning agents are prescribed to remove blood flow hindrance. Other than these medications, physical therapy is also necessary