Caudal paramedian midbrain syndrome

Mossuto-Agatiello L. Caudal paramedian midbrain syndrome. Neurology 2006; 66:1668-1671. Reviewed seminal cases of same by L'Hermitte (1941) and Garcin et al. (1971). Also reviewed five patients with evidence of paramedian midbrain infarction for clinical signs and symptoms. The authors suggest a unilateral lesion can produce bilateral symptoms. These include bilateral cerebellar ataxia, truncal ataxia, dysarthria, +/- eye movement disorders and palatal myoclonus. INO's, IIIn paresis/palsies can occur. MRI showed increased signal of the inferior olive. Rubral tremor may occur.