Weber syndrome
| Classification according to ICD-10 | |
|---|---|
| G46.3 | Weber syndrome |
| ICD-10 online (WHO version 2019) | |
The Weber syndrome (Synonyms: hemiplegia alternans oculomotorica superior , hemiplegia alternans superior and Weber Gubler's palsy ) is a classic brain stem syndrome defined by a circumscribed tissue damage in the area of the midbrain foot arises with portions of the substantia nigra destroyed and parts of the pyramidal tract , the Corticopontinus tract and the root fibers of the oculomotor nerve are disrupted. It is named after Hermann David Weber, a doctor of German descent who practiced in London and described it in 1863.
semiology
On the side of the lesion (ipsilateral) there is an oculomotor paresis , which leads to restricted eye mobility and double vision. A paralysis strabismus develops and the pupil is wide and rigid with light. Due to the deterioration of webs that intersect more caudally, it is on the opposite side ( contralateral ) to varying degrees, usually spastic hemiplegia ( hemiparesis ) with rigid tone increase the musculature and Dystaxie . Since the central (supranuclear) pathways to the nuclei of the cranial nerves VII. , IX. , X. and XII. can also be affected, central paresis of the facial, pharyngeal and tongue muscles on the contralateral side can also be observed.
causes
Weber syndrome is usually caused by a brainstem infarction caused by the closure of a branch ( ramus interpeduncularis ) of the posterior cerebral artery or the posterior choroid artery . Any other localized damage in this area is also conceivable, for example from an inflammatory focus.
literature
- Mathias Bähr, Michael Frotscher: Duus' neurological-topical diagnostics. Thieme, Stuttgart 2003, ISBN 3-13-535808-9 .
- Herbert Kaufmann: Strabismus . With the collaboration of W. de Decker u. a., Enke, Stuttgart 1986, ISBN 3-432-95391-7 .
- D. Schmidt: The classic brain stem syndromes. In: The ophthalmologist. 97, 2000, pp. 411-417, doi : 10.1007 / s003470070090 .
Individual evidence
- ^ A b Roche Lexicon Medicine, 5th ed., Urban & Fischer 2003
- ↑ a b Pschyrembel, de Gruyter Verlag, ISBN 3-11-007018-9
- ^ H. Weber: A Contribution to the Pathology of the Crura Cerebri. In: Medico-surgical transactions. Volume 46, 1863, pp. 121-140.1, ISSN 0959-5287 . PMID 20896209 . PMC 2147786 (free full text).
