MEDizzy
MEDizzy
Coffeerelated
Coffeerelatedabout 6 years ago

Where is the lesion In a pacient with right hemiparesis and left peripheral facial palsy: A)cortex of the left hemisphere B) left internal capsule C) left pons D)right pons E)left medulla F) left mesencephalic peduncle G)right mesencephalic peduncle

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about 6 years ago

A??

about 6 years ago

Let' try to find the answer by exclusion! A&B-any lesion of the left cortex and left internal capsule will affect the contralateral part of the body(a right paresis/plegia) so those 2 are not the answer. E - the motor nucleus of the facial nerve is in the pons not the medulla so a lesion in the medulla will not affect the facial nerve . F&G -a lesion in the mesencephalic peduncle will also give a central facial palsy (contralateral to the lesion) because it's above the nucleus of the facial nerve. THE CORRECT ANSWER IS C- THE LEFT PONS --in the pons the corticospinal tract (pyramidal) descends to the medulla abd it's still uncrossed (so any lesion here will give contralateral paresis) , in this case if the left corticospinal tract is affected in the pons there will be RIGHT hemiparesis/plegia; In the pons there is the motor nucleus of the facial nerve (which receives fibers from both hemispheres) so a lesion at the level of the nucleus will give a peripheral facial palsy, on the side of the lesion-in this case if the left motor nucleus of the facial nerve is affected there will be a LEFT peripheral facial palsy.This might happen in a inferior medial pontine syndrome, also called Foville syndrome. D- a lesion in the right pons will give opposite signs. I posted some images that will help you visualise this, just go to my profile😊 A doctor asked me this question in my neurology rotation and I did not know at the time so I had homework😧 Sorry for the late answer!

about 6 years ago

E? Is it LMN lesion?

about 6 years ago

Great thanks 🌻

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