Benedikt syndrome

Benedikt syndrome
Classification and external resources
Specialty	neurology
ICD-10	G46.3
ICD-9-CM	344.89
DiseasesDB	32780

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.

Characterization

It is characterized by the presence of an oculomotor nerve (CN III) palsy and cerebellar ataxia including tremor. Neuroanatomical structures affected include CNIII nucleus, Red nucleus, corticospinal tracts, brachium conjunctivum, and the superior cerebellar peduncle decussation. It is very similar in etiology, morphology and clinical presentation to Weber's syndrome; the main difference between the two being that Weber's is more associated with hemiplegia (i.e. paralysis), and Benedikt's with hemiataxia (i.e. disturbed coordination of movements).

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]

Treatment

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

References

↑ 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.
↑ 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
↑ 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.

External links

Cerebrovascular diseases (G45–G46 and I60–I69, 430–438)

Brain ischemia/
cerebral infarction
(ischemic stroke/TIA)

TACI, PACI	precerebral: Carotid artery stenosis cerebral: MCA ACA Amaurosis fugax Moyamoya disease

POCI	precerebral: Anterior spinal artery syndrome Vertebrobasilar insufficiency Subclavian steal syndrome brainstem: medulla Medial medullary syndrome Lateral medullary syndrome pons Medial pontine syndrome/Foville's Lateral pontine syndrome/Millard-Gubler midbrain Weber's Benedikt Claude's cerebral: PCA Lacunar stroke Dejerine–Roussy syndrome cerebellar

General	cerebral: Cerebral venous sinus thrombosis CADASIL Binswanger's disease Transient global amnesia

Intracranial hemorrhage
(hemorrhagic stroke)

Extra-axial	Epidural Subdural Subarachnoid

Cerebral/Intra-axial	Intraventricular

Brainstem	Duret haemorrhage

Aneurysm

Cerebral aneurysm
- Intracranial berry aneurysm
- Charcot-Bouchard aneurysm

Other/general

Cerebral vasculitis

Lesions of spinal cord and brain

Spinal cord/
vascular myelopathy

sensory: Sensory ataxia
Tabes dorsalis

motor: Motor neurone disease

mixed: Brown-Séquard syndrome
cord syndrome (Posterior
Anterior
Central/Syringomyelia)
Subacute combined degeneration of spinal cord (B12)
Cauda equina syndrome

Anterior spinal artery syndrome

Brainstem

Medulla (CN 8, 9, 10, 12)	Lateral medullary syndrome/Wallenberg PICA Medial medullary syndrome/Dejerine ASA

Pons (CN 5, 6, 7, 8)	Upper dorsal pontine syndrome/Raymond Céstan syndrome Lateral pontine syndrome (AICA) (lateral) Medial pontine syndrome/Millard-Gubler syndrome/Foville's syndrome(basilar) Locked-in syndrome Internuclear ophthalmoplegia One and a half syndrome

Midbrain (CN 3, 4)	Weber's syndrome ventral peduncle, PCA Benedikt syndrome ventral tegmentum, PCA Parinaud's syndrome dorsal, tumor Nothnagel's syndrome Claude's syndrome

Other	Alternating hemiplegia

Thalamic syndrome

Other

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