Millard–Gubler syndrome - Misplaced Pages

Medical condition

Millard–Gubler syndrome

Pons
Specialty	Neurology

Millard–Gubler syndrome is a lesion of the pons. It is also called ventral pontine syndrome.

Presentation

Symptoms result from the functional loss of several anatomical structures of the pons, including the sixth and seventh cranial nerves and fibers of the corticospinal tract. Paralysis of the abducens (CN VI) leads to diplopia, internal strabismus (i.e., esotropia), and loss of power to rotate the affected eye outward), and disruption of the facial nerves (CN VII) leads to symptoms including flaccid paralysis of the muscles of facial expression and loss of the corneal reflex. Disruption of the corticospinal tract leads to contralateral hemiplegia of the extremities.

Diagnosis

This syndrome is easier to diagnose today thanks to the technical advances in brain imaging (CT, MRI). It can also be identified based on the symptoms described above.

Management

Antiplatelets

Eponym

Millard–Gubler syndrome is named after two French physicians, Auguste Louis Jules Millard (1830–1915), who first identified the disorder in 1855, and Adolphe-Marie Gubler (1821–1879), who described the disease in a medical paper one year later.

References

Anatomy 530a at UWO (Functional Neuroanatomy)

External links

Classification	D ICD-10: G46.3 ICD-9-CM: 344.89
External resources	eMedicine: pmr/189

synd/1692 at Who Named It?

Cerebrovascular diseases including stroke

Ischaemic stroke

Brain	Anterior cerebral artery syndrome Middle cerebral artery syndrome Posterior cerebral artery syndrome Amaurosis fugax Moyamoya disease Dejerine–Roussy syndrome Watershed stroke Lacunar stroke
Brain stem	Brainstem stroke syndrome Medulla Medial medullary syndrome Lateral medullary syndrome Pons Medial pontine syndrome / Foville's Lateral pontine syndrome / Millard-Gubler Midbrain Weber's syndrome Benedikt syndrome Claude's syndrome
Cerebellum	Cerebellar stroke syndrome
Extracranial arteries	Carotid artery stenosis precerebral Anterior spinal artery syndrome Vertebrobasilar insufficiency Subclavian steal syndrome
Classification	Brain ischemia Cerebral infarction Classification Transient ischemic attack Total anterior circulation infarct Partial anterior circulation infarct
Other	CADASIL Binswanger's disease Transient global amnesia

Haemorrhagic stroke

Extra-axial	Epidural Subdural Subarachnoid
Cerebral/Intra-axial	Intraventricular
Brainstem	Duret haemorrhages
General	Intracranial hemorrhage

Aneurysm

Intracranial aneurysm
- Charcot–Bouchard aneurysm

Other

Signs and symptoms, and syndromes associated with lesions of the brain and brainstem

Cerebral cortex

ACA syndrome
MCA syndrome
PCA syndrome
Aphasia
Frontal lobe
- Expressive aphasia
- Abulia
Parietal lobe
Occipital lobe
Temporal lobe
- Cortical deafness
- Prosopagnosia

Subcortex

Basal ganglia
Thalamic syndrome

Cerebellum

Lateral
Medial
- Cerebellar ataxia

Brainstem

Medulla	Lateral medullary syndrome/Wallenberg PICA Medial medullary syndrome/Dejerine ASA
Pons	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	Weber's syndrome ventral peduncle, PCA Benedikt syndrome ventral tegmentum, PCA Parinaud's syndrome dorsal, tumor Claude's syndrome
Other	Alternating hemiplegia