Isolated peripheral facial and abducens nerve palsy could theoretically be caused by a caudal pontine infarction, but as far as we know, there has been no published case history which has demonstrated this point. We describe the cases of two hypertensive patients who showed combined peripheral facial and abducens nerve palsy without other neurologic symptoms or signs. Other than hypertension, there was no identifiable etiology. Magnetic resonance imaging demonstrated compatible isolated ipsilateral ischemic infarction of the caudal tegmental pons. The present cases indicate that a well-placed small pontine infarction can cause isolated peripheral facial and abducens nerve palsy.

Keywords:
Brainstem infarction, Pons, Facial nerve, Abducens nerve
1.
Silverman IE, Liu GT, Volpe NJ, Galetta SL: The crossed paralysis: The original brain-stem syndrome of Millard-Gubler, Foville, Weber and Raymond-Cestan. Arch Neurol 1995;52:635–638.
2.
Jonsson L, Thuouss KA, Stenguist M, Engstrom M, Stalberg E, Bergitrom K, Lyttkens L, Svedberg A: Acute peripheral facial palsy simulating Bell’s palsy in a case of probable MS with a clinically correlated transient pontine lesion on MRI. ORL J Otorhinolaryngol Relat Spec 1991;53:632–635.
3.
Martinez Garcia FA, Salmeron P, Morales Ortiz A, Villaverde R: Pontine hemorrhage as a cause of peripheral facial paralysis. Rev Neurol 1996;24:984–986.
4.
Donaldson D, Rosenberg NL: Infarction of abducens nerve fascicle as cause of isolated sixth nerve palsy related to hypertension. Neurology 1988;38:1654.
5.
Johnson LN, Hepler RS: Isolated abducens nerve paresis from intrapontine fascicular abducens nerve injury. Am J Opthalmol 1989;108:459–461.
6.
Fukutake T, Hirayama K: Isolated abducens nerve palsy from pontine infarction in a diabetic patient. Neurology 1992;42:2226.
7.
Kim JS, Kang JK, Lee SA, Lee MC: Isolated or prominent ocular motor nerve palsy as a manifestation of brain-stem stroke. Stroke 1993;24:581–586.
8.
Glaser JS, Bachynski B: Infranuclear disorders of eye movement; in Glaser JS (ed): Neuro-opthalmology. Philadelphia, Lippincott, 1990, p 366.
9.
Tatu L, Moulin T, Bogousslavsky J, Duvernoy H: Arterial territories of human brain: Brainstem and cerebellum. Neurology 1996;47:1125–1135.
10.
Fisher CM, Caplan LR: Basilar artery branch occlusion: A cause of pontine infarction. Neurology 1971;21:900–905.
1999
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.