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

Patient	Additional signs	Blink reflex^2-151	Associated lesions
1	1, 2, 3, 4, 5, 6	Contralateral. hemiparesis	Normal	5	PCA, cerebellum, and supratentorial vascular encephalopathy
1	Complete	Contralateral. hemiparesis	Normal	5	PCA, cerebellum, and supratentorial vascular encephalopathy
2	2, 3, 6	No	Normal	2	No
2	Incomplete	No	Normal	2	No
3	1, 2, 3, 4, 6	Transient ipsilat. Facial weakness with sparing the upper face, skew deviation	Normal	3	Old lesions: MCA, basal ganglia, cerebellum
3	Complete		Normal	3	Old lesions: MCA, basal ganglia, cerebellum
4	1, 3, 4	No	Normal	2	No
4	Incomplete	No	Normal	2	No
5	3, 4	No	Normal	x	No
5	incomplete	No	Normal	x	No
6	1, 2, 3, 5, 6	Ipsilateral facial weakness with sparing the upper face	R1-i slightly delayed (12,1 ms), loss of R2-i /R2c-i	5	Old lesion: MCA
6	complete	Ipsilateral facial weakness with sparing the upper face	R1-i slightly delayed (12,1 ms), loss of R2-i /R2c-i	5	Old lesion: MCA
7	1, 2, 4, 6	Skew deviation	R2-i side difference (not significant), R2c-i side difference	1	No
7	complete	Skew deviation		1	No
8	1, 2, 3, 4, 6	Skew deviation	R2-i/R2c-i side difference	3	No
8	complete	Skew deviation	R2-i/R2c-i side difference	3	No
9	1, 2, 3, 4, 5, 6	No	R2-i/R2c-i delayed	3	Cerebellum
9	complete	No	R2-i/R2c-i delayed	3	Cerebellum
10	1, 2, 3, 4, 5, 6	No	Loss of R2-i/R2c-i	4	Cerebellum
10	complete	No	Loss of R2-i/R2c-i	4	Cerebellum
11	1, 2, 3, 4, 5, 6	Transient ipsilateral facial weakness with sparing the upper face	R2-i/R2c-i delayed	4	Cerebellum
11	complete		R2-i/R2c-i delayed	4	Cerebellum
12	1, 2, 3, 4, 5, 6	No	Loss of R2-i/R2c-i, loss of R2c-c	4	Cerebellum
12	complete	No	Loss of R2-i/R2c-i, loss of R2c-c	4	Cerebellum
13	1, 3, 5, 6	Skew deviation	Loss of R2-i/R2c-i	4	Cerebellum
13	complete	Skew deviation	Loss of R2-i/R2c-i	4	Cerebellum
14	2, 6	Ipsilateral facial weakness of peripheral type, skew deviation	R2-i delayed, R2c-c side difference (not significant)	3	No
14	incomplete		R2-i delayed, R2c-c side difference (not significant)	3	No
15	1, 2, 3, 4, 5, 6	Ipsilateral facial weakness with sparing the upper face, skew deviation	Loss of R2-i/R2c-i, loss of R2-c/R2c-c	6	Old lesion: basal ganglia
15	complete		Loss of R2-i/R2c-i, loss of R2-c/R2c-c	6	Old lesion: basal ganglia

↵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