Foville Syndrome Research Articles

Teaching Video Neuro Images : Foville syndrome

A 68-year-old man with a pontine telangiectasia on anticoagulation developed a left conjugate gaze palsy and right hemiparesis (figure; video 1). Brain MRI showed acute pontine hemorrhage extending dorsally and to the left.

Foville syndrome due to peripontine infarction: A case report

Introduction. Stroke is the most common cause of mortality and morbidity. Pontine infarction leads to an ischemic stroke in pontine. Variability of its clinical presentation depends on the location of infarct. One of them is Foville syndrome, which features contralateral motor hemiparesis or hemiplegia, ipsilateral cranial nerve palsy, and facial palsy. There were few cases reported especially in Indonesia. We report a case of an elderly female with Foville syndrome due to stroke in Peripontine caused by infarction. Case presentation. A 63-years-old female presented with acute vertigo, sudden deafness, slurred speech, and hemiparesis on the right side of her body. The onset was 14 hours before hospital admission. The patient had a history of poor controlled diabetes and hypertension. The results of the neurological examination showed left facial nerve weakness, facial numbness, peripheral deafness in the left ear, and right-side weakness of body. Radiological examination of the Head CT-scan showed lesions in the left paramedian pontine region, bilateral cerebellum and multiple lacunar infarction. Patient was given dual antiplatelet therapy, and vascular risk factor medication. Pasien was discharged after 8 days under treatment with minor disability. Conclusion. We report a rare case of Foville syndrome due to pontine infarction. Clinical signs and symptoms correlate well with anatomic involvement. The treatments depend on the etiologies and risk factors.

A CASE OF FOVILLE SYNDROME

60 year old diabetic and hypertensive female presented to casualty with right hemiplegia and hemianesthesia with lower motor neuron type of facial nerve palsy and loss of pain, temperature on left side of the face. She had difculty adduction and abduction on left eye with horizontal nystagmus in the contralateral eye when abducted while vertical movements were preserved. MRI brain was done which showed acute focal non hemorrhagic infarct in the left hemi pons along with partial basilar artery thrombosis. Hence a diagnosis of foville syndrome with inter nuclear opthalmoplegia was made. Classically foville syndrome is characterised by ipsilateral sixth nerve palsy, lower motor neuron facial nerve palsy, fth sensory nuclear palsy along with contralateral hemiparesis and hemisensory loss. The patient was started on single antiplatelet along with high intensity statin. On follow up after 3 months patients power improved.

Fovilles Syndrome a Case to Remember Case Report

The Foville’s Syndrome is a rare clinical feature of stroke or brain hemorrhage. This is very rare brain stem syndrome and only few cases have been reported worldwide. A case of Foville's syndrome secondary to infarction at the left paramedian pontine region, which was diagnosed and treated at Annapurna Neurological institute and allied Science, Kathmandu, Nepal. A 62 years old gentleman presented with acute headache with sudden onset of vertigo, tinnitus, slurred speech, difficulty while swallowing and numbness and hemiparesis on the right side of the body. The aim of this study was to report a rare case of Foville's syndrome with the infarction at the left paramedian pontine region. The clinical manifestations were well correlated with anatomical involvement. The CT-scan of head, Magnetic Resonance Imaging (MRI), MR-Angiogram (MRA) sequence of cerebral and carotid, etc. helped in the diagnosis of the case along with the other lab investigations.

Foville Syndrome Due to Pontine Hemorrhage and Pontine Infarct: Case Series

Foville Syndrome is a rare clinical feature of stroke or brain hemorrhage. Few cases have been reported worldwide particularly in Asian, Indonesia, Aceh. Patient 1: We report the case of a female 64 years old patient, was admitted in the Neurology Department of Dr. Zainoel Abidin General Hospital, Banda Aceh, Indonesia, for an abrupt onset of right body side weakness two day before admission. That weakness was preceded by acute headaches and rotatory vertigo with vomiting. with hypertension history since 5 years. Physical examination found paralysis of right oculomotor movements with intact response of pupils to light, right trochlear nerve palsy, left ipsilateral facial nerve palsy, and right hemiparesis which constitute of Foville syndrome. The brain CT scan shown in the right pontine hypodensity area is pontine infarct. Etiological investigations done to chronic hypertension. Patient received antiplatelet therapy and control of vascular risk factors for secondary prevention (hypertension theraphy), and physiotherapy as treatment with clinical improvement. And she has been discharge 8 days later. Patient 2: 45-year-old right-handed female, was admitted in the Neurology Department of Dr. Zainoel Abidin General Hospital, Banda Aceh, Indonesia, for an abrupt onset of right body side weakness two day before admission. That weakness was preceded by acute headaches and rotatory vertigo with vomiting. with hypertension history since 5 years. Physical examination found paralysis of right oculomotor movements with intact response of pupils to light, right trochlear nerve palsy, left ipsilateral facial nerve palsy, and right hemiparesis which constitute of Foville syndrome. The brain CT scan shown spontaneous hemorrhage in the left pontine’s. Etiological investigations done to chronic hypertension. Patient received therapy control of vascular risk factors for secondary prevention (hypertension theraphy), and physiotherapy as treatment with clinical improvement. And she has been discharge 10 days later. The diagnosis and management of brainstem stroke bring a considerable burden to the healthcare system, the patient, the family members, and the society at large. The slow increase in the global burden of stroke has been steadily increasing.

Crossed brainstem syndrome revealing bleeding brainstem cavernous malformation: an illustrative case

BackgroundSince the nineteenth century, a great variety of crossed brainstem syndromes (CBS) have been described in the medical literature. A CBS typically combines ipsilateral cranial nerves deficits to contralateral long tracts involvement such as hemiparesis or hemianesthesia. Classical CBS seem in fact not to be so clear-cut entities with up to 20% of patients showing different or unnamed combinations of crossed symptoms. In terms of etiologies, acute brainstem infarction predominates but CBS secondary to hemorrhage, neoplasm, abscess, and demyelination have been described. The aim of this study was to assess the proportion of CBS caused by a bleeding episode arising from a brainstem cavernous malformation (BCM) reported in the literature.Case presentationWe present the case of a typical Foville syndrome in a 65-year-old man that was caused by a pontine BCM with extralesional bleeding. Following the first bleeding episode, a conservative management was decided but the patient had eventually to be operated on soon after the second bleeding event.DiscussionA literature review was conducted focusing on the five most common CBS (Benedikt, Weber, Foville, Millard-Gubler, Wallenberg) on Medline database from inception to 2020. According to the literature, hemorrhagic BCM account for approximately 7 % of CBS. Microsurgical excision may be indicated after the second bleeding episode but needs to be carefully weighted up against the risks of the surgical procedure and openly discussed with the patient.ConclusionsIn the setting of a CBS, neuroimaging work-up may not infrequently reveal a BCM requiring complex multidisciplinary team management including neurosurgical advice.

Dorsolateral pontine syndrome and contralateral fourth nerve palsy in a post‐stroke patient

Foville syndrome is a well‐recognised clinical entity and is defined as a caudal dorsolateral pontine syndrome with the following ipsilateral clinical findings: facial hemi‐hypoesthesia, ocular abd...

FIVE CASES OF ACUTE HYPOACUSIA/DEAFNESS SECONDARY TO ARTERIAL AND VENOUS CEREBROVASCULAR DISEASE

I present five cases of acute onset hypoacusia (four unilateral and one bilateral), all of different physiopathological mechanisms and vascular territories, secondary to either arterial or venous causes. First case is a 39-year-old male with Left Middle Inferior Pontine Syndrome (Foville Syndrome) with associated Vertebro-Basilar Insufficiency (VBI) secondary to Spontaneous Vertebral Artery Dissection (SVAD) and secondary hypoacusia. Case two, is a 76-year-old female with right Anterior Inferior Cerebellar Artery (AICA) Syndrome generating a lateral pontine infarct with hypoacusia as an initial presentation. Case three, is a 77-year-old male presenting a left Superior Cerebellar Artery (SCA) infarct with hypoacusia as an initial presentation. Case four, a 79-year-old female patient presenting sudden onset bilateral hypoacusia secondary to Basilar Artery (BA) thrombosis. Finally, case five, is a 23-year-old post-partum female presenting a right Transverse Venous Sinus Thrombosis (CVST) presenting with acute hypoacusia as only clinical manifestation. Keywords: hypoacusia, deafness, cerebrovascular disease.

Teaching Video Neuro Images : Foville syndrome

A 68-year-old man with a pontine telangiectasia on anticoagulation developed a left conjugate gaze palsy and right hemiparesis (figure; video on the Neurology ® Web site at [Neurology.org][1]). Brain MRI showed acute pontine hemorrhage extending dorsally and to the left. [1]: http://neurology.org/lookup/doi/10.1212/WNL.0000000000002658

Christian Albrecht Jensen (1792–1870): An artistic illustration of Foville’s syndrome

Foville's syndrome, a neurological brainstem syndrome, was described in France in 1858. By chance, a talented portrait painter, CA Jensen, probably illustrated the syndrome at the same time in Copenhagen. This note illustrates the importance of observation in both neurology and art and the variety in interpretation of the same picture by viewers.

Foville's syndrome with ipsilateral internuclear ophthalmoplegia due to spontaneous pontine hemorrhage

A 30-year-old male presented to the emergency department with a complaint of acute headache with pain in the right eye and simultaneous weakness and numbness on his left side. Results of ophthalmic examinations showed limited abduction and adduction only in the right eye, while the vertical movement was normal. Mild ptosis with concurrent miosis oculus dexter was also found. A neurological examination revealed left hemiplegia, left hemiparesthesia, left-side sensory ataxia, right facial palsy, and right facial analgesia. Computer tomography revealed a 2.4-cm high-density hemorrhage in the bilateral dorsal aspect of pons, more at the right side. Foville's syndrome with ipsilateral internuclear ophthalmoplegia was diagnosed and the patient received supportive treatment. The patient later complained of left hearing loss and the brainstem auditory evoked potential study suggested a peripheral lesion. Follow-up magnetic resonance imaging studies at the 3rd and 10th months showed old pontine hemorrhage with right hypertrophic olivary degeneration (HOD). We reported a rare case of Foville's syndrome with ipsilateral internuclear ophthalmoplegia due to spontaneous pontine hemorrhage. The clinical manifestations correlated well with anatomical involvement. The sequela of HOD after potine hemorrhage should be monitored for the possible late-onset movement disorder.

Achille Louis Foville's Atlas of Brain Anatomy and the Defoville syndrome

Achille Louis Foville's atlas of brain anatomy (1844) is one of the most artistic and detailed works on neuroanatomy in the medical literature. The outstanding drawings by the 2 artists, Emile Beau and Frédéric-Michel Bion, highlight all the philosophy, ability, and sensibility of A.L. Foville in carefully dissecting the superficial and deep structures of the brain and spinal cord. Several plates show true brain fiber dissections of high artistic and academic value. As a result of an early misrecognition in the medical literature, "inferior Foville syndrome" has been wrongly attributed to Achille Louis Foville rather than his son, Achille Louis François Foville (1832-1887), also called Defoville. Therefore, we suggest that Defoville, who actually described the pontine syndrome for the first time in the neurological literature, deserves to be credited for this syndrome and that the syndrome should be called the Defoville syndrome. Through analyzing the political and scientific events in France in the 19th century, we highlight the invaluable contributions of A.L. Foville and his son to the history of neuroanatomy and neurology.

Fluctuating Foville's Syndrome Caused by a Pontine Angioma in a Patient with a Polycystic Kidney

Fluctuating Foville's Syndrome Caused by a Pontine Angioma in a Patient with a Polycystic Kidney

A Case of Pontine Hematoma with Foville's Syndrome in Childhood

A Case of Pontine Hematoma with Foville's Syndrome in Childhood

OCCLUSION OF THE BASILAR ARTERY

The present report dealt with thirteen autopsied cases of basilar artery occlusion. The age of the patients ranged from fifty one to seventy six years with a mean age of fifty six years, and there were eleven males and two females. Basilar artery occlusion was found in one in every 160 autopsies. The average length of the clinical course of the disease was five months. Many patients had a history of hypertension, diabetes mellitus, and cerebrovascular attacks. The neurological signs and symptoms of basilar artery occlusion extremely varied and were complicated. In our series, occular bobbing, palatal myoclonus, Foville syndrome, and Millard - Gubler syndrome are significant. Arteriosclerotic thrombosis is the most important etiologic factor. The site of occlusion was most frequently encountered in the lower third of the basilar artery. Areas of softening were prominent in the midbrain and the pons. In the cerebellum, softenings were present particularly in the areas supplied by the superior cerebellar artery. Infarcts in the thalamus and the temporo-occipital lobes supplied by the posterior cerebral artery were observed very frequently. The distribution of softening was related to the site of occlusion of the basilar artery and the collateral circulation through the Willis ring.

Two Cases of Foville's Syndrome

Two Cases of Foville's Syndrome

Foville's Syndrome as a Complication of Phaeochromocytoma

Foville's Syndrome as a Complication of Phaeochromocytoma