Table 2

Neurological disturbances, blink reflex responses, outcome, and associated lesions of 15 patients with infarction of the lower brain stem. Patients with normal blink reflexes (1–5) more often had an incomplete Wallenberg’s syndrome (WS) than patients with loss or delay of R2-i/R2c-i (no 6–13). According to the outcome there was no significant difference between the two groups

PatientWS signs2-150Additional signsBlink reflex2-151Outcome2-152Associated lesions
11, 2, 3, 4, 5, 6Contralateral. hemiparesisNormal5PCA, cerebellum, and supratentorial vascular encephalopathy
Complete
22, 3, 6NoNormal2No
Incomplete
31, 2, 3, 4, 6Transient ipsilat. Facial weakness with sparing the upper face, skew deviationNormal3Old lesions: MCA, basal ganglia, cerebellum
Complete
41, 3, 4NoNormal2No
Incomplete
53, 4NoNormalxNo
incomplete
61, 2, 3, 5, 6Ipsilateral facial weakness with sparing the upper faceR1-i slightly delayed (12,1 ms), loss of R2-i /R2c-i5Old lesion: MCA
complete
71, 2, 4, 6Skew deviationR2-i side difference (not significant), R2c-i side difference1No
complete
81, 2, 3, 4, 6Skew deviationR2-i/R2c-i side difference3No
complete
91, 2, 3, 4, 5, 6NoR2-i/R2c-i delayed3Cerebellum
complete
101, 2, 3, 4, 5, 6NoLoss of R2-i/R2c-i4Cerebellum
complete
111, 2, 3, 4, 5, 6Transient ipsilateral facial weakness with sparing the upper faceR2-i/R2c-i delayed4Cerebellum
complete
121, 2, 3, 4, 5, 6NoLoss of R2-i/R2c-i, loss of R2c-c4Cerebellum
complete
131, 3, 5, 6Skew deviationLoss of R2-i/R2c-i4Cerebellum
complete
142, 6Ipsilateral facial weakness of peripheral type, skew deviationR2-i delayed, R2c-c side difference (not significant)3No
incomplete
151, 2, 3, 4, 5, 6Ipsilateral facial weakness with sparing the upper face, skew deviationLoss of R2-i/R2c-i, loss of R2-c/R2c-c6Old lesion: basal ganglia
complete
  • 2-150 1=Ipsilateral Horner’s sign; 2=ipsilateral impairment of facial pain and/or temperature sensation; 3=palsy of cranial nerve IX and/or X; 4=contralateral impairment of pain and temperature sensation over trunk and limbs; 5=ipsilateral limb dysmetria; 6=astasia and gait ataxia.

  • 2-151 R1-i=R1 to stimulation ipsilaterally to lesion; R1-c=R1 to stimulation contralaterally to lesion; R2-i=R2 to stimulation ipsilaterally to lesion; R2-c=R2 to stimulation contralaterally to lesion; R2c-i=R2c to stimulation ipsilaterally to lesion; R2c-c=R2c to stimulation contralaterally to lesion.

  • 2-152 Outcome at time of discharge from neurological ward (modified Rankin scale): 0=no symptoms at all; 1=no significant disability despite symptoms; 2=slight disability; unable to carry out all previous activities but able to look after own affairs without assistance; 3=moderate disability; requiring some help; but able to walk without assistance; 4=moderately severe disability; unable to walk without assistance; and unable to attend to own bodily needs without assistance; 5=severe disability; bedridden; incontinent; and requiring constant nursing care and attention; 6=death; x=no acute infarction