Nothnagel syndrome

Nothnagel syndrome is a rare midbrain syndrome that involves the tectum of the midbrain (quadrigeminal plate) and superior cerebellar peduncles .

Clinical presentation

Classically, the syndrome involves the oculomotor nerve fascicles and superior cerebellar peduncle, leading to ipsilateral CN III palsy and limb ataxia respectively .

Pathology

Although it can be caused by stroke, especially hemorrhages rather than infarctions, it is more commonly seen due to neoplasm extending from the tectal plate into the superior cerebellar peduncles .

Radiographic features

Lesions are in the tectum of the midbrain with imaging characteristics depending on the underlying cause.

History and etymology

The syndrome was first described by Hermann Nothnagel (1841-1905), a German-Austrian physician, in 1879 .