MRCP PACES Brainstem Syndromes Midbrain Syndromes
  • Weber’s syndrome
    • Ipsilateral third nerve palsy
    • Contralateral hemiparesis (involvement of cerebral peduncle containing corticospinal fibres which decussate in the medulla)
  • Benedikt’s syndrome (posterior cerebral artery)
    • Ipsilateral third nerve palsy
    • Contralateral chorea, athetosis, tremor or cerebellar ataxia (involvement of the red nucleus which receives projections from the contralateral hemisphere and projects to the ipsilateral cerebellum)
  • Claude’s syndrome (posterior cerebral artery)
    • Ipsilateral third nerve palsy
    • Contralateral ataxia (involvement of the superior cerebellar peduncle)
  • Parinaud’s syndrome
    • Typically caused by tumours of the pineal gland
    • Compress on the vertical gaze centre, resulting in vertical gaze palsy
    • Vertical Doll’s not affected as the lesion is supra-nuclear
    • Irregular pupils
    • Eyelid retraction
    • Convergence nystagmus on upward gaze
    • Loss of accommodation
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