DrVirgo
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Ipsilateral facial weakness &contralateral extremities weakness->lesion in pons
PLEASE EXPLAIN YOUR ANSWER IF YOU CHOSE ONE.
Thanks. 
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| dr_arc
Forum Senior
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Posts: 156
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the combination of ipsilateral face involvement and contralateral UMN signs is s/o of a brainstem lesion.
but the eye findings confuse me
pontine gaze centre= ipsilateral gaze. so if lesion in pons=loss of ipsilateral gaze. ipsilateral in this case would be left, since left facial weakness. so eye should be unable to look to left. this eye cannot look to the right.
frontal gaze centre= contralateral gaze, so lesion in left = loss of right gaze which is what this eye shows.but then what explains the faial weakness. the fact that the entire face including forehead is involved indiactes that this is a facial nerve involvement and that can happen with a pontine lesion where the facial nerve curves its way out around the abducens nucleus.so i guess i will stick to pontine hge. also h/o HT
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| brutus25
Forum Junior
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Abducens nerve lesions at its exit from inferior pons --> intern strabismus of the ipsilateral eye --> diplopia - when one tries to turn his eyes towards the affected side
!!!
If the lesion extends dorsally , so that it also includes the abducens nucleus ( which includes the center for horizontal conjugate eye movements from RPPF ) there might be a paralysis of the lateral ocular eye movements , in which case , both eyes are forced away from the lesion.
This explanation is from Kaplan`s neuroanatomy - so the obvious answer would be left latero-dorsal pons
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| Ivonne
Find a way or make one
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Seems to be left CN VI, VII affected along with contralateral motor deficit.
Where?
Left pons
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| dr19
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C....???
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| tamerbashir
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C
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