Benedikt syndrome

Benedikt syndrome
Other names	Paramedian midbrain syndrome
Specialty	Neurology

Benedikt syndrome, also called Benedikt's syndrome or paramedian midbrain syndrome, is a rare type of posterior circulation stroke of the brain, with a range of neurological symptoms affecting the midbrain, cerebellum and other related structures.

Ipsilateral third nerve palsy presenting with ptosis, abduction of eye. Contralateral flapping tremor.

Causes

Benedikt syndrome is caused by a lesion (infarction, hemorrhage, tumor, or tuberculosis) in the tegmentum of the midbrain and cerebellum. Specifically, the median zone is impaired. It can result from occlusion of the posterior cerebral artery ^[1] or paramedian penetrating branches of the basilar artery. ^[2]

Diagnosis

• Oculomotor nerve palsy: eyeball gazing downward and outward position, diplopia, miosis, mydriasis, and loss of accommodation reflex.
• Contralateral loss of proprioception and vibration sensations.
• Cerebellar ataxia: involuntary movements.

Treatment

Deep brain stimulation may provide relief from some symptoms of Benedikt syndrome, particularly the tremors associated with the disorder. ^[3]

See also

• Claude's syndrome
• Wallenberg syndrome

References

1. Akdal G, Kutluk K, Men S, Yaka E (Jan 2005). "Benedikt and "plus-minus lid" syndromes arising from posterior cerebral artery branch occlusion". Journal of the Neurological Sciences. 228 (1): 105–107. doi:10.1016/j.jns.2004.09.029. PMID   15607218. S2CID   2317640.
2. AMA citation: Greenberg DA, Simon RP. Chapter 3. Disorders of Equilibrium. In: Greenberg DA, Simon RP, eds. Clinical Neurology. 7th ed. New York: McGraw-Hill; 2009. http://www.accessmedicine.com/content.aspx?aID=5146162. Accessed July 21, 2012
3. Bandt SK, Anderson D, Biller J (Oct 2008). "Deep brain stimulation as an effective treatment option for post-midbrain infarction-related tremor as it presents with Benedikt syndrome". Journal of Neurosurgery. 109 (4): 635–639. doi: 10.3171/JNS/2008/109/10/0635 . PMID   18826349.