skip to main content

Foville Syndrome – Pontine Gaze Palsy and Facial Palsy — SCE Neurology MCQ

Instant feedback + full explanation. One question, done properly.

HardCerebrovascular DiseaseFoville Syndrome – Pontine Gaze Palsy and Facial PalsySCE Neurology

A 45-year-old man presents with conjugate horizontal gaze palsy to the left — he cannot look to the left with either eye. He also has a left peripheral facial nerve palsy (LMN). There are no limb signs. MRI brain shows a left pontine infarct. What is the neuroanatomical explanation?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Left ventral pontine infarct affecting the left CN VI nucleus (or PPRF) and the left CN VII fascicle as it wraps around the CN VI nucleus

The abducens (CN VI) nucleus is the pontine horizontal gaze centre — it contains motor neurons for the ipsilateral lateral rectus AND interneurons that project via the contralateral MLF to the contralateral CN III nucleus (for adduction). Damage to the left CN VI nucleus causes complete conjugate gaze palsy to the left (both eyes cannot look left). The CN VII fascicle loops around the CN VI nucleus before exiting the brainstem — a pontine lesion at this level damages both, causing ipsilateral horizontal gaze palsy + ipsilateral LMN facial palsy = Foville syndrome. A: Lateral medullary syndrome involves different structures. C: Midbrain infarcts affect CN III. D: Medial medullary syndrome affects CN XII and corticospinal tract. E: A right-sided lesion would cause right gaze palsy.

Reference: Clinical Neuroanatomy