Ipsilateral hemiplegia

Ipsilateral hemiplegia and the Wallenberg syndrome Arch Neurol. 1984 Feb;41(2):179-80. doi: 10.1001/archneur.1984.04050140077029. Authors S K Dhamoon, J Iqbal, G H Collins. PMID: 6691820 DOI: 10.1001/archneur.1984.04050140077029 Abstract We documented the anatomic basis for hemiplegia occurring on the same side of the body as the lateral. Ipsilateral hemiplegia in a lateral medullary infarct--Opalski's syndrome J Neuroimaging. 2003 Jan;13(1):83-4. doi: 10.1111/j.1552-6569.2003.tb00162.x. Authors Yasuyuki Kimura 1 , Hiroyuki Hashimoto, Masafumi Tagaya, Yuko Abe, Hideki Etani. Affiliation 1 Division of.

Clinical Cases of Cranial Nerves at New York Institute of

Ipsilateral hemiplegia and the Wallenberg syndrom

Ipsilateral hemiparesis was defined as hemiparesis ipsilateral to recent stroke lesions. Patients with ipsilateral hemiparesis were examined with functional neuroimaging studies including transcranial magnetic stimulation (TMS) and functional MRI A patient with a right internal capsule and thalamic hemorrhage showed ipsilateral hemiplegia.MRI at 10 months after the cerebral hemorrhage demonstrated Wallerian degeneration, which could be traced to the ipsilateral anterior funiculus at the cervical level In a review of the literature (including our case), hemiplegia was ipsilateral to the infarction in four of the five patients with VA dissection, but contralateral in all six patients with atherosclerotic disease of the VA (p=0.01)

Ipsilateral hemiplegia in a lateral medullary infarct

From Wikipedia, the free encyclopedia Alternating hemiplegia (also known as crossed hemiplegia) is a form of hemiplegia that has an ipsilateral cranial nerve palsies and contralateral hemiplegia or hemiparesis of extremities of the body. The disorder is characterized by recurrent episodes of paralysis on one side of the body In the alternating or crossed hemiplegias, CN paralysis is ipsilateral to the lesion, and body paralysis is contralateral. In such cases, CN paralysis is of the lower motor neuron type, and the location of the affected CN helps determine the level of the lesion in the brainstem It is diagnosed by finding motor (muscle) paralysis on the same (ipsilateral) side as the lesion and deficits in pain and temperature sensation on the opposite (contralateral) side. This is called ipsilateral hemiplegia and contralateral pain and temperature sensation deficits

Hemiparesis is a condition related to hemiplegia whose symptoms include a significant loss of strength and mobility on one side of the body—but without full paralysis. Some people with hemiplegia develop the condition after a bout of hemiparesis. Others may go from being hemiplegic to having hemiparesis after undergoing physical therapy OBJECTIVE: We present a case of ipsilateral glossoplegia & hemiplegia with acute medullary & cervical cord ischemic stroke in a pediatric patient. BACKGROUND: Tongue deviation can result from unilateral supranuclear, nuclear or CN XII lesion. Supranclear lesions of the corticobulbar tract cause tongue deviation towards the side of hemiplegia along with ipsilateral facial weakness A rare variant of lateral-medullary syndrome, Opalski syndrome, manifests as ipsilateral hemiplegia; however, the anatomic basis is not established. Therefore, we generated a directionally encoded color map (figure, B) using diffusion tensor imaging techniques and superimposed the images (figure, C and D) Ipsilateral Hemiplegia and the Wallenberg Syndrome. Surjit K. Dhamoon, MD; Javaid Iqbal, MD; George H. Collins, MD. Author Affiliations. From the Departments of Neurology (Drs Dhamoon and Iqbal) and Pathology (Dr Collins), State University of New York, Upstate Medical Center, Syracuse Ipsilateral hemiparesis is a rare and challenging sign in clinical neurological practice. Although the etiology of this manifestation is poorly understood, recent studies have attempted to probe the pathomechanism of this sign with advanced radiological techniques

Ipsilateral hemiparesis in ischemic stroke patient

Ipsilateral hemiplegia caused by right internal capsule

Hemiparesis ipsilateral to the facial paralysis suggests a cortical or subcortical lesion, whereas contralateral hemiparesis suggests a pontine lesion near the facial motor nucleus Reviewing the MRI brain revealed the diagnosis (Fig. 1, Fig. 2) of a small vesicular NCC lying in the right half of medulla below the decussating of the pyramidal tracts likely, causing an ipsilateral isolated hemiplegia in a toddler.Download : Download full-size image Fig. 1. T2W image (magnified) showing a bright cystic lesion with faint increased surrounding signals, lying in the ventral. [Ipsilateral central-type facial palsy and contralateral hemiparesis associated with unilateral medial medullary infarction: a case report] Clinical pictures of medial medullary syndrome are variable, depending upon the extent of the lesion. Facial palsy has rarely been observed even in medullary infarction

Hemimedullary infarct with ipsilateral hemiplegia: a

  1. ative touch and proprioception on the entire contralateral body area, a contralateral hemiplegia with positive Babinski sign, and paralysis of the ipsilateral half of the tongue. The structures involved include the medial lemniscus, the pyramids, and the hypoglossal nerve root
  2. In patients with hemimedullary syndrome, the presence of ipsilateral, rather than contralateral hemiplegia, is rare. Objective To describe a patient with an infarction in the right hemimedulla with an ipsilateral motor deficit due to dissection of the right vertebral artery (VA) and to assess whether the ipsilateral hemiplegia may be the result.
  3. Ipsilateral Hemiplegia in a Lateral Medullary Infarct- Opalski's Syndrome. Yasuyuki Kimura MD. Corresponding Author. Division of Stroke and Hypertension, Department of Internal Medicine, Osaka National Hospital, Japan
  4. Background Ipsilateral sensory motor symptoms associated with carotid artery stenosis are rare, and few reports are available in the literature.. Case Description We report the case of a 50-year-old man who presented with right hemiplegia that recurred 14 months later. A left hemisphere watershed infarction was detected. Repeated angiograms showed a left internal carotid occlusion and a right.
  5. Its occurrence has been explained by the existence of one or more 23 sympathetic cortico-hypothalamo-spinal pathways crossing at the spinal level and inhibiting contralateral sweating. 8 21 Very rarely, as in our patient, contralateral (segmental) hemihyperhidrosis can be associated with ipsilateral Horner's syndrome (the so-called hemiplegia.
  6. Since her hemiplegia was ipsilateral to the side of the subdural hematoma, the possibility of Kernohan's notch was considered. Gross deviation of the crura of the midbrain to the left side was noted on detailed review of the CT scan of the head done prior to the evacuation of the hematoma (Figure 1)

Discussion. Opalski syndrome is a rare variant of Wallenberg syndrome, with ipsilateral hemiplegia. 1 Pathological and radiological studies have shown that ipsilateral hemiplegia is caused by a lesion in the corticospinal fibers caudal to the pyramidal decussation.1, 2, 3 Unilateral sensory impairment below the sensory dermatome usually suggests involvement of the spinal cord Using ipsilateral motor signals in the unaffected cerebral hemisphere as a signal platform for brain-computer interfaces in hemiplegic stroke survivors. Bundy DT(1), Wronkiewicz M, Sharma M, Moran DW, Corbetta M, Leuthardt EC

variant of lateral-medullary syndrome, Opalski syndrome, 1 manifests as ipsilateral hemiplegia; however, the anatomic basis is not established.2 Therefore, we generated a directionally encoded color map (figure, B) using diffusion tensor imaging techniques and superimposed the images (figure, C and D). These suggest that involvement of the. The middle cerebral artery (MCA) can be divided into 2 main territories, the superior and inferior. If MCA stem is occluded, this will results in complete MCA syndrome which one will be presented with hemiplegia, hemisensory loss, hemianopsia, temporary ipsilateral gaze palsy, and global aphasia (if on dorminant side) or hemi-neglect (non-dorminant)

Weber's syndrome, also known as midbrain stroke syndrome or superior alternating hemiplegia, is a form of stroke that affects the medial portion of the midbrain. It involves oculomotor fascicles in the interpeduncular cisterns and cerebral peduncle so it characterizes the presence of an ipsilateral lower motor neuron type oculomotor nerve palsy and contralateral hemiparesis or hemiplegia Hemiconvulsion-hemiplegia epilepsy syndrome (HHE) is a clinical syndrome of infancy or early childhood that is associated with seizures, cerebral hemiatrophy and transient or permanent epilepsy. It refers to the characteristic holohemispheric global atrophy of one hemisphere, that is independent of any vascular territory and subsequently follows a causative episode of prolonged clonic seizures.

Alternating hemiplegia - Wikipedi

On the same side, with reference to a given point, e.g., a dilated pupil on the same side as an extradural hematoma. Synonym(s): homolateral 13 Bernex, 19046 52, F Ac/hematoma Rt hemiplegia Motor aphasia Rt basal ganglia hemorrhage Death 14 Dupré & Camus, 1905 43, M Ac/infection Lt hemiplegia Aphasia, lt mydriasis, confusion Lt peri-rolandic infarction, rt CST atrophy (Ж) Death 15 Pic, 1906 64, M Ac/hematoma Rt hemiplegia Dysphasia Rt occipital hemorrhage Deat Horner's syndrome and ipsilateral laryngeal hemiplegia in three cats. Holland CT. Horner's syndrome is described in three cats associated with wounds to the ventrolateral neck. In each case, ipsilateral laryngeal hemiplegia was observed on laryngoscopy. This finding provided strong evidence to support a diagnosis of second order Horner's. Ipsilateral hemiplegia caused by right internal capsule and thalamic hemorrhage: demonstration of predominant ipsilateral innervation of motor and sensory systems by MRI, MEP, and SEP Neurology , 46 ( 1996 ) , pp. 1146 - 114 The classic sensory signs of lateral medullary syndrome (LMS) include the loss of spinothalamic sensation in the ipsilateral face and contralateral hemibody and extremities. The variants of sensory abnormalities include contralateral or bilateral facial sensory changes, 123 partial involvement of the face, 13 or changes in the sensory level of.

Hemiplegia - Physiopedi

  1. Ipsilateral HCHB could also occur when there is absence of decussation of pyramidal motor tracts. Though rare, this was reported by Hosokawa et al in a patient with ipsilateral hemiplegia caused by right internal capsule and thalamic bleeding. 12 However, our patient developed contralateral hemiplegia, ruling out this rare possibility
  2. caused ipsilateral abducens nerve palsy, ipsilateral supranu-clear facial palsy and contralateral hemiparesis. Case Report The patient was a 62-year-old right-handed man with a history of hypertension and diabetes mellitus but no history of neurological problems. After experiencing a sudden onset of vertigo and diplopia and right hemiplegia.
  3. Ipsilateral hemianaesthesia of the face. Cerebellar dysfunction. Speech and swallowing disorders. Horners syndrome. Occlusion of the paramedian branches of the basilar arteries causes middle alternating hemiplegia. Contralateral hemiplegia. Medial deviation of the eyeball
  4. When ipsilateral hemiplegia is associated with symptoms of a lateral medullary syndrome, it corresponds to the submedullary syndrome of Opalski.1 Some neuropathological case reports have shown that the infarction is located lower than that found in Wallenberg′s syndrome.2 Opalski's syndrome has been attributed to an occlusion of the vertebral artery.3

Brown-Séquard syndrome - Wikipedi

After a neck trauma, a 26-year-old woman developed sudden left headache and vomiting. On admission, she displayed left Horner syndrome with ipsilateral reduced facial sensation to pain and temperature that was crossed in the body, affecting the right limbs. In addition, she had left hemiparesis with.. hemiplegia/hemiparesis due to damage to fascicular oculomotor fibers and motor fibers in the cerebral peduncle.& o Claude's syndrome: ipsilateral oculomotor nerve palsy with contralateral ataxia due to involvement of the superior cerebellar peduncle. & o Benedikt's syndrome: ipsilateral oculomotor nerve palsy with contralateral tremo The technique is commonly used and usually preferred to ipsilateral acupuncture (IAT) for treating post-stroke hemiplegia or sciatica . Several studies have shown effects of CAT on pain [ 6 , 7 ], dizziness [ 8 ], herpes zoster [ 9 ], and stroke [ 10 ] In 1905 German neurologist Albert Knapp recognized hemiparesis alternans, or motor deficit of the ipsilateral oculomotor nerve and contralateral hemiparesis, as a clinical manifestation typical of temporal lobe tumors that compress the ipsilateral cerebral peduncle through uncal herniation. 32 Knapp was aware of the occurrence of IH in this.

Contralateral acupuncture versus ipsilateral acupuncture in the rehabilitation of post-stroke hemiplegic patients: a systematic review. Kim MK(1), Choi TY, Lee MS, Lee H, Han CH. Author information: (1)Department of Korean Internal Medicine, Dongguk University Ilsan Hospital, Goyang, South Korea Recently, there have been some reports regarding hyperkinetic motor behaviours contralateral to hemiplegia in acute stroke.1 2 These behaviours are probably the reflection of early plastic changes of brain maps and circuits after an acute lesion and an active process induced by disinhibition to establish new compensatory pathways.1 I encountered a peculiar case of a patient with right. Ipsilateral hemiplegia and the Wallenberg syndrome. Arch Neurol. 1984; 41(2):179-80 (ISSN: 0003-9942) Dhamoon SK; Iqbal J; Collins GH. We documented the anatomic basis for hemiplegia occurring on the same side of the body as the lateral medullary infarction

Living with Hemiplegia and Hemiparesis: Causes, Treatment

  1. A 14-month-old boy with alternating hemiplegia of childhood, an idiopathic disorder of early childhood causing episodic hemibody tonic spasms and hemiplegia, showed repetitive jerks of abduction of the ipsilateral eye during the spells. The mechanism of this ocular motor abnormality is unknown but may be unique to this disorder
  2. Weber's syndrome: ipsilateral oculomotor nerve palsy with contralateral hemiplegia/hemiparesis due to damage to fascicular oculomotor fibers and motor fibers in the cerebral peduncle. Claude's syndrome: ipsilateral oculomotor nerve palsy with contralateral ataxia due to involvement of the superior cerebellar peduncle
  3. A patient with Wallenberg's syndrome and an inferior cerebellar infarction developed progressive hemiplegia ipsilateral to the infarction as cerebellar edema emerged. An MRI showed diagonal displacement of the medulla with impaction of the pyramids against the clivus; the hemiplegia resolved after posterior fossa decompression
  4. hemiplegia — hemiparesis; n. paralysis of one side of the body. It is caused by disease affecting the opposite (contralateral) hemisphere of the brain . The new mediacal dictionary. Alternating hemiplegia — refers to a form of hemiplegia that has an ipsilateral presentation on one side of the body, and a contralateral presentation on the.
  5. Occipital epilepsy is characterised by seizures which usually begin with oculomotor or elementary visual symptoms and often spread to other cortical and subcortical regions. We think that the present case report is of particular interest because of the nature of partial status comprising positive (clonic jerks of eyes and left face) and negative motor components (left hemiplegia) with.

3. Discussion. Crossed motor weakness, known as the Millard Gubler syndrome, is classically attributed to lesions in the pons .In this setting, facial weakness is due to lower motor neuron injury at the nucleus level and is frequently associated with abducens nerve palsy, contralateral cerebellar ataxia and one-and-a half syndrome , .On the other hand, crossed motor weakness is a rare. Most often the ipsilateral cerebral peduncle is compressed, resulting in contralateral hemiparesis or hemiplegia. In addition the cerebral peduncle on the side opposite the space-occupying lesion may be compressed against, or indented by, the free edge of the tentorium cerebelli

Alternating hemiplegia-also known as Crossed hemiplegia- is a form of hemiplegia that has an ipsilateral and contralateral presentation in different parts of the body. The disorder is characterized by recurrent episodes of paralysis on one side of the body. [1] There are multiple forms of alternating hemiplegia, Weber's syndrome, middle alternating hemiplegia, and inferior alternating hemiplegia • Ipsilateral paraplegia • Ipsilateral hemiparesis • Contralateral hemiplegia • Contralateral quadriparesis .ANS:C A patient with a stroke has symptoms on that opposite side of that stroke, which is called contralateral. One-sided flaccidity is called hemiplegia. A. Ipsilateral means that same side. Para refers to that lower extremities. D The additional presence of ipsilateral peripheral facial nerve involvement has been described as an eight-and-a-half syndrome (Cases B-1 and B-3), and the bilateral horizontal gaze limitation associated with bilateral facial nerve involvement is described as 16 syndrome (Case B-2) [7, 8]. These stereotypic combinations should be. alternating abducens hemiplegia with bells palsy on ipsilateral side. syndrome of foville. A 6 H with dorsal extension also involves 10!-Destruction of medial lemniscus , results in contralateral loss of propioception/2pt tactile - Destruction of MLF resulting in IN

The presence of contralateral hemiparesis and ipsilateral facial weakness is referred to as cross-hemiplegia. [pediatricneuro.com] CLINICAL PERSPECTIVES ON MUSCLE STRENGTH AND WEAKNESS IN POSTSTROKE HEMIPLEGIA The capacity to produce muscle force, or strength, involves- 1 Per Hemiplegia one is a more severe version of the other. Should be merged to hemiparesis as that is the broader term. Happy to see a merge. Doc James (talk · contribs · email) (if I write on your page reply on mine) 08:29, 12 September 2014 (UTC) Support merge of Hemiplegia into Hemiparesis Jytdog 03:32, 15 September 2014 (UTC The child developed an ipsilateral hemiplegia, partially improved during the first month of follow-up. Sequential cerebral magnetic resonance imaging (MRI) and proton magnetic resonance spectroscopy (1H-MRS) at 6, 15, 30 days of follow-up showed a cytotoxic edema in the left hemisphere and a subsequent necrosis Brainstem Lesions Pt 1. STUDY. PLAY. lesion of the Medial Longitudinal Fasc on the opposite side from the abnormal gaze. Internuclear Ophthalmoplegia. A lesion where can lead to abnormal horizontal gaze in one direction? What is the term for this? lower pons btw the trigeminal and abduciens CNs

Ipsilateral Glossoplegia & Hemiplegia: Acute Medullary

We have demonstrated that hr-EEG coregistered with MRI is capable of identifying reorganization of motor control in stroke patients with recovered hemiplegia. This may involve a total or partial shift to the ipsilateral hemisphere, or there may be relocation in the same hemisphere Physical therapists involved in the treatment of patients with hemiplegia should be aware that motor functions of the ipsilateral , nonparetic upper extremity may also be affected adversely by unilateral brain lesions Medulla oblongata. 1. Medulla Oblongata DR BHAVIN J PATEL SR NEUROLOGY GMC KOTA. 2. Anatomy 3Cm long. Located at the caudal portion of brainstem Upper limit is cerebello-pontine angle Transverse plane that above C1 (suboccipital n) intersects upper border of atlas dorsally and centre of dens ventrally marks lower limit. 3 There are 3 specific brainstem lesions that involve crossed motor deficits with an UMN paralysis of the contralateral body caused by damage to the corticospinal fibers and a flaccid paralysis of the ipsilateral face caused by cranial nerve damage. An inferior alternating hemiplegia would involve. a den hemiplegia. The recognition of multiple neuromas as a disease entityprecededRecklinghausen'sclassical descriptionof neurofibromatosis by 33 years.2 Bruns described the myriad clinical manifestations of the disease and called attention to the incidence of largedistorted limbs.3 The bone alterations in multiple neurofibromatosis were no

Opalski syndrome Neurolog

limb hemiplegia after ipsilateral brain hemisphere lesions. Keywords: Corticospinal tract, neural remodeling, hypoplasia, hemiplegia Introduction Cases of limb hemiplegia after ipsilateral brain hemisphere stroke can be encountered by chance in clinical practice ( Table 1 ) [1-17]. Limb movement is mainly mediated by the cortico-spinal tract (CST) exosmosis occurred after hemiplegia in this study, HPS could be excluded. From the view of hemodynamics, detached emboli typically flow to the large blood vessels with fastest velocity. In this patient, embolic detachment may block the ipsilateral middle cerebral artery, resulting in right limb paralysis. Right anterior cerebra Hemiconvulsion-hemiplegia-epilepsy (HHE) syndrome is an uncommon outcome of prolonged focal status epilepticus in childhood. The prolonged focal motor seizure usually occurs during the course of a febrile illness and is followed by hemiplegia ipsilateral to the side of convulsions. This is accompanied by radiologic evidence of acute cytotoxic edema in the affected hemisphere followed by. Ipsilateral Motor Deficit Resulting from a Subdural Hematoma and a Kernahan Notch Kendall M. Jones,1·2 Joachim F. Seeger, and Mark T. Yoshino A Kernahan notch (compression of the cerebral peduncle against the tentorial edge by a contralateral mass, producing ipsilateral hemiplegia or hemiparesis) is usually seen in pa

Ipsilateral Hemiplegia and the Wallenberg Syndrome JAMA

Millard-Gubler syndrome (ventral pontine syndrome) -- ipsilateral CN VI and VII palsy with contralateral hemiplegia of extremities; Sparing of vertical eye movements (CN III exits brainstem just above lesion) Thus, may also have miosis b/l; One and a half syndrome (seen in a variety of brainstem infarctions Background: Motor dysfunction in the contralateral hand has been well characterised after stroke. The ipsilateral hand has received less attention, yet may provide valuable insights into the structure of the motor system and the nature of the recovery process. By tracking motor function of both hands beginning in the acute stroke period in patients with cortical versus subcortical lesions, we. [Case of pontine infarction causing alternating hemiplegia with ipsilateral abducens nerve palsy and contralateral supranuclear facial nerve palsy]. Ogawa K, Tougou M, Oishi M, Kamei S, Mizutani T. Rinsho Shinkeigaku, 48(2):135-138, 01 Feb 2008 Cited by: 0 articles | PMID: 1832630

Ipsilateral hemiplegia or hemiparesis Initially flaccid then spastic pain from NURS 3102 at University of North Carolina, Charlott Hemiplegia: Causes and Treatments for Partial Paralysis Medically reviewed by Seunggu Han, M.D. Hemiplegia is a severe paralysis on one side of your body caused by brain damage Key Words: Cerebrovascular Accident, Paresis, Shoulder Joint, Biomechanics February 2005 Ipsilateral Shoulder Kinematics in Hemiplegia 97 I n stroke, functional impairment of the involved upper limb and the occurrence of shoulder pain are tralateral hemisphere in unilateral stroke in the form of significant magnetic resonance imaging changes,22. •Contralateral hemiplegia. Ipsilateral VI nerve palsy (but no abnormality of movements of contralateral eye). Summary of symptoms suggestive of pontine infarctions •Combination of ipsilateral facial weakness •Severe dysarthria •Dysphagia •Contralateral hemiparesi It is characterized by contralateral hemiplegia/hemiparesis as well as hemisensory loss with ipsilateral hypoglossal palsy (ipsilateral tongue weakness and atrophy) from involvement of CN XII nucleus. Other manifestations e.g. vertigo, nausea, ipsilateral limb ataxia are also reported

Contralateral hemiplegia Ipsilateral 6 & / or LMN 7 17. Hemiparesis 1. Abducent paresis 2. Horizontal gaze paralysis Foville Contralateral sideIpsilateral side Site of lesion Syndrome Contra. 18. Hemiparesis9th, 10th Avellis Hemiparesis11th, 12th Jackson Contralateral side Ipsilateral side Site of lesion Syndrome 19 Alternating Hemiplegia. Alternating hemiplegia refers to a form of hemiplegia that has an ipsilateral and contralateral presentation in different parts of the body. The disorder is characterized by recurrent episodes of paralysis on one side of the body. This type of syndrome can result from a unilateral lesion in the brainstem affecting both upper motor neurons and lower motor neurons Horner's syndrome and ipsilateral laryngeal hemiplegia in three cats Horner's syndrome and ipsilateral laryngeal hemiplegia in three cats Holland, C. T. 1996-09-01 00:00:00 Horner â s svndrome and ipsilateral 1Larvngeal hemipulegia in three cats C. T. Holland 29 Dunkley Avenue, New Lambton, New South Wales, 2305 Australia Journal of Small Animal Practice (1996) 37,442-446 ABSTRACT Homerâ s. Benedikt syndrome is associated with a large midbrain lesion that encompasses the regions damaged in both Weber syndrome and Claude syndrome, and, as such, presents with symptoms of both of those syndromes: ipsilateral oculomotor nerve paralysis, contralateral hemiplegia, cerebellar tremor, and rubral ataxia Ipsilateral CN III palsy and contralateral involuntary movements and hemiplegia (if it affects the corticospinal tracts) MortizBenedikt. Eponymous Brainstem stroke Syndromes. Weber Syndrome. Similar to Benedikt's but more severe contralateral weakness

Figure 1 from Using ipsilateral motor signals in theHemiplegia (One side paralysis) - YouTubeMotor paralysis clinical

Ipsilateral to the damaged hemisphere, fine motor tasks of simple visual motor reaction time, grip and pinch strength, finger tapping, and Purdue Pegboard performance were tested. Physical therapists involved in the treatment of patients with hemiplegia should be aware that motor functions of the ipsilateral, nonparetic upper extremity may. Ipsilateral HCHB could also occur when there is absence of decussation of pyramidal motor tracts. Though rare, this was reported by Hosokawa et al in a patient with ipsilateral hemiplegia caused by right internal capsule and thalamic bleeding.12 However, our patient developed contralateral hemiplegia, ruling out this rare possibility Syndrome Lesion location Structures involved Clinical features Comment webers Midbrain base CN-3 fibers , cerebral peduncle Ipsilateral 3-CN palsy, Contralateral hemiplegia Usually vascular in origin Claude's Midbrain tegmentum CN-3 fibers , red nucleus , Superior cerebellar peduncle 13. Brainstem • Crossed hemiplegia • Ipsilateral LMN CN palsy & contralateral hemiplegia • Cerebellar signs. 14. Points in history helping localization • Grade of weakness - dense or not • Uniformity of weakness - • UMN facial palsy - present or not • Cortical symptoms - Focal seizures;Dysphasia;Apraxia • Cranial nerve.