ISOLATED PONTINE INFARCTIONS WITH PROMINENT IPSILATERAL MIDFACIAL SENSORY SIGNS

Background Pontine infarctions may produce combined motor, sensory, ce rebellar, and cranial nerve dysfunction. Midline sensory complaints an d facial pain are uncommon. Case Descriptions Three patients are descr ibed with hypoesthesia and numbness of the midline facial area associa ted with dysarthria and contralateral hemiparesis due to pontine strok es. MRI demonstrated isolated ipsilateral ischemic infarctions of the ventral pens. Conclusions Pontine infarctions can produce diverse sens ory features. Ipsilateral midfacial sensory defect has been rarely rep orted. The clinicoanatomic basis for the ipsilateral midfacial sensory defect described is unknown. Involvement of the dorsal trigeminothala mic tract or fiber tracts related to central regions of the face, loca ted in the medial part of the midbrain, could help to explain these da ta. The symptoms could be due to direct damage or to edema resulting f rom the infarct. In some patients, midfacial sensory complaints, parti cularly of the ala nasi, could be an early sign of major pontine defic its and may be important to determine appropriate treatment.