Millard–Gubler syndrome is a lesion of the pons. It is also called ventral pontine syndrome.Anatomy 530a at UWO (Functional Neuroanatomy)
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Presentation

Symptoms result from the functional loss of several anatomical structures of the pons, including the sixth and seventh cranial nerves and fibers of the

corticospinal tract The corticospinal tract is a white matter motor pathway starting at the cerebral cortex that terminates on lower motor neurons and interneurons in the spinal cord, controlling movements of the limbs and trunk. There are more than one million neur ...

Paralysis Paralysis (also known as plegia) is a loss of motor function in one or more muscles. Paralysis can also be accompanied by a loss of feeling (sensory loss) in the affected area if there is sensory damage. In the United States, roughly 1 in 50 ...

of the

abducens The abducens nerve or abducent nerve, also known as the sixth cranial nerve, cranial nerve VI, or simply CN VI, is a cranial nerve in humans and various other animals that controls the movement of the lateral rectus muscle, one of the extraocula ...

(CN VI) leads to diplopia, internal strabismus (i.e.,

esotropia Esotropia is a form of strabismus in which one or both eyes turns inward. The condition can be constantly present, or occur intermittently, and can give the affected individual a "cross-eyed" appearance. It is the opposite of exotropia and usual ...

), and loss of power to rotate the affected eye outward), and disruption of the facial nerves (CN VII) leads to symptoms including flaccid paralysis of the muscles of facial expression and loss of the

corneal reflex The corneal reflex, also known as the blink reflex or eyelid reflex, is an involuntary blinking of the eyelids elicited by stimulation of the cornea (such as by touching or by a foreign body), though it could result from any peripheral stimulus. S ...

. Disruption of the

leads to contralateral hemiplegia of the extremities.

Diagnosis

This syndrome is easier to diagnose today thanks to the technical advances in brain imaging (CT, MRI). It can also be identified based on the symptoms described above.

Management

Antiplatelets

Eponym

Millard–Gubler syndrome is named after two French physicians,

Auguste Louis Jules Millard Auguste Louis Jules Millard (30 April 1830 in Paris – 13 November 1915 in Paris) was a French physician. He studied medicine in Paris, where in 1860 he attained the title of ''médecin des hôpitaux''. He subsequently worked at the Hôpital des ...

(1830–1915), who first identified the disorder in 1855, and

Adolphe-Marie Gubler Adolphe-Marie Gubler (5 April 1821 – 20 April 1879) was a French physician and pharmacologist born in Metz. Originally a student of botany, he began his medical studies in 1841 at Paris, where he was a pupil of Armand Trousseau (1801–1867). I ...

(1821–1879), who described the disease in a medical paper one year later.

References

External links