Millard - Gubler's syndrome

Gubler also known as outlined's syndrome, cross-cutting outreach-facial paralysis - hemiplegia syndrome. Pathology Disease found in most brain tumors, followed by brain hemorrhage, cerebral infarction less see the bridge. Oppression or paracrine tumor center artery of the brain affected bridge corticospinal tract, and medial lemniscus, the medial longitudinal-pons, cerebellum beam, Outreach nuclear caused nerve. Clinical features of the lesion side of the abducens nerve palsy, facial paralysis and contralateral limb paralysis. Performance of diplopia, lateral esotropia, eye outreach obstacles medial paresis, eyelid is not closing, nasolabial lighter, nervous altercation outside of the contralateral, lower limb paralysis. Differential diagnosis (1) brain tumors (pons rumor) Refer Lhermitte's syndrome. (2) pontine hemorrhage (pons haemorrhage) often include sudden, severe headache there, dizziness, vertigo, plunged, vomiting, diplopia, the side of his face numb, and other symptoms. In the sense of early onset part of the reservation, but often within a few minutes into a deep coma. Bleeding often side of the bridge since the first brain, there Millard - Gubler's syndrome. But often bleeding rapidly spreading on both sides, on both sides there were limbs and facial paralysis of limbs formed a flaccid paralysis, "needle-like" pupil, sustained high fever state, in the earliest difficulty breathing. Should be done very carefully to prevent herniation lumbar puncture. Brain imaging examination that can be diagnosed. (3) Bridge infarction (pons 362002) may be short-lived precursor ischemic attack history. More quiet when the disease, the symptoms often hours or longer period of time gradually increased awareness often remain clear, feeling and movement disorders focal neurologic deficits were larger. CSF clear, the pressure is not high. Brain imaging examination for the effective, safe and accurate diagnostic methods. (4) the syndrome should avoid confusion with the following diseases 1.Foville's syndrome : If Millard - Gubler's syndrome accompanied by lateral gaze to the disease obstacles, they were called Foville's syndrome (also known as the center of the bridge adjacent brain syndrome). 2.Brissaud - Sicard syndrome : means a facial muscle spasm and contralateral hemiplegia. most of the lower pons intramedullary or extramedullary tumors.