Benedikt syndrome; paramedian midbrain syndrome

Etiology

• ischemic stoke
• hemorrhagic stroke
• brain tumor
• tuberculosis

Epidemiology

• rare

Pathology

• stroke in the posterior circulation affecting tegmentum of midbrain & cerebellum
• occlusion of the posterior cerebral artery or paramedian penetrating branches of the basilar artery
• affected midbrain structures include:
  • oculomotor nucleus
  • red nucleus
  • corticospinal tracts
  • brachium conjunctivum
  • superior cerebellar peduncle

Clinical manifestations

• cranial nerve 3 palsy
• hemi-ataxia
• tremors

Management

• deep brain stimulation may be of some benefit

More general terms

• disease/disorder primarily affecting brain
• syndrome