Abstract

Brainstem stroke syndromes are a group of rare neurological conditions affecting the midbrain, pons, and medulla of varied etiology affecting the posterior circulation. We report a rare case of a 32-year-old woman who presented with drooping of the right upper eyelid for three days associated with giddiness, and weakness of left upper and lower limbs. Ocular examination revealed right oculomotor nerve palsy. Systemic neurological examination revealed reduced power in her left upper and lower limbs. Left-sided cerebellar signs with an ataxic gait were present. MRI Brain showed an acute non-hemorrhagic infarct in the right paramedian region of the midbrain involving red nucleus and fascicles of oculomotor nerve suggestive of Benedikt syndrome. This case highlights the importance of systemic evaluation of a patient who presents to the neuro-ophthalmology OPD and stresses the need for a multidisciplinary approach in treatment and neuro-rehabilitation.