All are true about Weber's syndrome EXCEPT
(D) Involvement of Dorsal mid-brain[?]WEBER'S SYNDROME (superior alternating hemiplegia) is a form of stroke characterized by the presence of an ipsi-lateral oculomotor nerve palsy and contra-lateral hemiparesis or hemiplegia.oIt is caused by mid-brain infarction as a result of occlusion of the paramedian branches of the posterior cerebral artery or of basilar bifurcation perforating arteries. VENTRAL MID-BRAIN LESION (WEBER'S SYNDROME)On side of lesionOn side opposite lesion*. Diplopia and dilated pupil (oculomotor nerve)*. Hemiplegia (mainly upper limb and face (pyramidal tract)*. Ataxia (right dentothalamic tract before crossing)PCA P1 level of branches to mid-brain) (Weber's syndrome)-Manifestations: At level of mid-brain-Motor Weakness - Contra-lateral hemiplegia (upper & lower extremity).-Corticospinal tract: Corticobulbar fibers in the cerebral peduncle-Ipsilateral Lateral gaze weakness & diplopia: CN 3 fibers (LMN).-PE eye movements: Patient is unable to move eye up, down, or medially in the epsilateral side.-Pupillary dilatation: If Edinger-Westphal nucleus are involved.DORSAL MID BRAIN LESION (CLAUDE'S SYNDROME)On side of lesionOn side opposite lesion*. Diplopia & dilated pupil (oculomotor nerve)*. Loss of pain and temp. Sensation from trunk and limbs. Spinothalamic tract)*. Horner's syndrome (sympathetic)*. Loss of pain and temp, sensation from face (Trigeminothalamic tract)*. Pupil may be dilated or constricted and ptosis may be partial or complete*. Loss of position sense in limbs (Medial lemniscus)*. Resting tremor (Red nucleus)*. Ataxia (left Dentatothalamic tract after crossing)*. Monoplegia (Pyramidal tract)MID-BRAIN EPONEMIC SYNDROMES-Nothnagel's syndrome: Injury to the superior cerebellar peduncle causes ipsi-lateral oculomotor palsy and-contra-lateral cerebellar ataxia.-Benedikt's syndrome: Injury to the red nucleus results in ipsi-lateral oculomotor palsy and contra-lateral tremor, chorea and athetosis.-Claude's syndrome: Nothnagel's syndrome + Benedikt's syndrome, by injury to both the red nucleus and the superior cerebellar peduncle.-P1 Syndromes: mid-brain, subthalamic & thalamic signs, (due to disease of the proximal P1 segment of the PCA or its-Penetrating branches (thalamogeniculate, Percheron & posterior choroidal arteries)-Claude's syndrome (3rd nerve palsy with contra-lateral ataxia)-Weber's Syndrome (3rd nerve palsy with contra-lateral hemeplegia)-Dejerine-Roussy syndrome: Contra-lateral hemisensory loss followed later by an agonising, searing or burning pain in the effected areas.-P2 Syndromes: Cortical temporal and occipital lobe signs, due to occlusion of the P2 segment distal to the junction of the PCA with the posterior communicating artery.-Balint's syndrome, disorder of orderly visual scanning of environment results form infarction secondary to low flow in "watershed" between distal PCA & MCA territories (after cardiac arrest) shows with features of Palinopsia & Simultanagnosia,
Contra-lateral hemiplegia
Ipsi-lateral Oculomotor nerve palsy
Contra-lateral Parkinsonism
Involvement of Dorsal mid-brain
C.N.S.