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Neurology, Vol 50, Issue 6 1859-1862, Copyright © 1998 by American Academy of Neurology

ARTICLES

Isolated voluntary facial paresis due to pontine ischemia

PP Urban, S Wicht, J Marx, S Mitrovic, C Fitzek and HC Hopf
Department of Neurology, University of Mainz, Germany.

We describe a patient with isolated voluntary facial paresis due to a unilateral lacunar lesion in the contralateral mediodorsal middle base of the pons. Transcranial magnetic stimulation confirmed the involvement of supranuclear corticofacial tract fibers and sparing of the corticolingual and corticospinal connections. This observation demonstrates that the fibers conveying voluntary orofacial activation descend mediodorsally at the level of the middle pons and that the fibers conveying emotional activation may be assumed to converge below this level.


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