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Lateral Pontine Syndrome Definition, Symptoms, Causes, Treatment

   

Lateral pontine syndrome is defined as a condition in which lesion occurs in pons. Lateral pontine syndrome closely resembles lateral medullary syndrome the only difference is location of occurrence. It occurs in pons and cranial nerve nuclei of the pons. Lateral pontine syndrome is also known as Marie foix syndrome or Marie foix alajouanine syndrome. It is a type of brain stem stroke syndromes. Lateral pontine syndrome involves following structures.


  • Corticospinal tract
  • Spinothalamic tract
  • Vestibule cochlear nerve
  • Cerebellar tracts
  • Nucleus of facial nerve.

There are four scientists named theophile alajouanine, pierre marrie, french neurologists and charles foix who contributed in describing lateral pontine syndrome. Lateral pontine syndrome shows symptoms which are according to the site involved. When occlusion occurs in anterior inferior cerebellar artery. It leads to lesion or infarction in pons I.e. caudal pons. But if occlusion occurs in superior cerebellar artery then rostral pons is involved. In lateral pontine syndrome, lesions in spinothalamic tract causes fever and severe pain in contralateral limbs and body. If lesion occurs in descending hypothalamic fibers, it causes ipsilateral horner syndrome I.e. anhydrosis, ptosis and meiosis. If lesions occur in vestibular nuclei and it's pathway, then patient feels nausea and vomiting. Patient feels no pain and temperature sensations if lesion occurs in spinal tract.

Lateral Pontine Syndrome Definition, Symptoms, Causes, Treatment

Lateral Pontine Syndrome Symptoms


The symptoms of lateral pontine syndrome is according to the site of brain involved. There are five to six main sites which are involved in causing lateral pontine syndrome. Lesions in trigeminal nerve I.e. rostral pons leads to strong numbness in one side of face, mastication muscles become weak and jaw turns towards lesional side of mouth. Lesions in facial nerves cause facial paralysis. Lesions in vestibular nuclei causes nausea, vomiting, nystagmus and vertigo. Lesions in spinal cord tract and nucleus lead to loss of sensations.

Lateral Pontine Syndrome Causes


Lateral pontine syndrome occurs due to lesions specifically in pons. Lesions cause interruption in blood supply. Anterior inferior cerebellar artery and circumferential arteries are mainly involved in causing lateral pontine syndrome. There are 5 to 6 main sites in which lesions leads to lateral pontine syndrome. These sites are spinal tract and nucleus, trigeminal nerve, lateral spino thalamic tract, facial nerve and nucleus, spinal trigeminal nucleus and tract, descending sympathetic tract, middle and inferior cerebellar peduncle, cochlear nuclei and intra axial nerve fibers. All these sites show different symptoms if occlusion occurs in any one of these.

Lateral Pontine Syndrome Treatment


Treatment of lateral pontine syndrome is dependant on its diagnosis. Treatment of lateral pontine syndrome involves symptoms relieving medications which only relief symptoms not the basic cause. Symptoms of lateral pontine syndrome varies according to the site involved, so there are different medications for symptoms of different sites.  Neuro surgery is performed to clear out lesion in arteries. Sometimes blood thinning agents are prescribed to remove blood flow hindrance. Other than these medications, physical therapy is also necessary. As physical therapy helps a lot in regulation of blood flow in whole body.

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