Millard-Gubler syndrome

Millard-Gubler syndrome, also known as ventral pontine syndrome, is one of the crossed paralysis syndromes, which are characterized by cranial nerves VI and VII palsies with contralateral body motor or sensory disturbances .

Clinical presentation

• ipsilateral facial and contralateral body hemiplegia due to pyramidal tract involvement
• isotropism and diplopia that is worsened while the patient looks toward the lesion
• ipsilateral facial paresis and loss of corneal reflex

Pathology

Lesions in ventral aspect of the caudal pons involving the fibers of the cranial nerves VI and VII as well as corticospinal tract .

Etiology

Causes vary by age :

• young
  • tumor
  • demyelination (e.g. MS)
  • viral infection (e.g. rhombencephalitis)
• older
  • vascular

Radiographic features

Lesions are in ventral aspect of caudal pons with imaging characteristics depend on underlying cause .

History and etymology

The syndrome was first described separately by Auguste Millard (1830-1915) and Adolphe-Marie Gubler (1821-1879), French physicians, in 1856 .