Brain Stem Lesions

A unilateral lesion of the medial lemniscus, usually vascular in origin, is followed by an impairment or loss of vibration, proprioception, and reduced or abolished sense of discriminative touch on the contralateral half of the body if the lesion is situated above the crossing of the fibers in the medulla. Owing to the segmental arrangement of the fibers in the long ascending tracts there frequently will not be a complete unilateral sensory or motor impairment. Circumscribed areas of sensory loss are not rare, and the regions presenting sensory impairment are only distinctly outlined. y Because of the medial placement of the medial lemniscus, the midline cranial nerves or medial longitudinal funiculus are affected, causing ocular paresis that helps to define the level of the brain stem involved.

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