Department of Neurology, Kyung Hee University Hospital, #23 Kyunghee-daero, Dongdaemun-gu, Seoul, 02447, Republic of Korea.
BMC Neurol. 2023 Oct 17;23(1):370. doi: 10.1186/s12883-023-03363-8.
Stroke is rarely accompanied with peripheral facial paralysis and supranuclear palsy of the hypoglossal nerve. Both sides of the motor cortex innervate the hypoglossal nucleus; therefore, unilateral lesions of the upper motor neurons rarely result in contralateral lingual paresis. We report a rare case of crossed syndrome with associated hyperacute peripheral hemifacial paralysis and contralateral lingual paresis after a lower pontine tegmentum ischemic stroke.
A 73-year-old man presented with symptoms of hyperacute peripheral hemifacial paralysis. Upon protrusion, the patient's tongue deviated to the contralateral side, without fasciculation or atrophy. Brain imaging showed focal ischemic stroke in the pontine tegmentum. However, lingual hemiparesis and multimodal neuroimaging findings differed.
We suggest that cortico-hypoglossal fibers pass through the dorsal pontine. This case of crossed syndrome is a rare report of a lower pontine tegmentum ischemic stroke resembling an upper motor neuron lesion of the contralateral hypoglossal nerve.
中风很少伴有周围性面瘫和舌下神经核上性麻痹。运动皮质的两侧都支配舌下神经核；因此，上运动神经元的单侧病变很少导致对侧舌肌无力。我们报告了一例罕见的交叉综合征病例，伴有急性周围性半侧面瘫和对侧舌肌无力，发生在下脑桥被盖部缺血性卒中后。
一名 73 岁男性出现急性周围性半侧面瘫症状。当患者伸出舌头时，舌头偏向对侧，无束颤或萎缩。脑部影像学显示脑桥被盖部局灶性缺血性卒中。然而，舌肌偏瘫和多模态神经影像学检查结果不同。
我们认为皮质舌下纤维通过背侧脑桥。这种交叉综合征病例是下脑桥被盖部缺血性卒中的罕见报告，类似于对侧舌下神经上运动神经元病变。
