Fauville's Alternating Syndrome is a central paresis that involves unilateral involvement of the cranial nerves and opposing sensory and motor systems. Due to the fact that lesions can be of different shapes and dangers, experts distinguish an extensive group of syndromes. Diagnosis of the disease is carried out by examining the patient's neurological system. To obtain accurate results and establish a diagnosis, it is necessary to use MRI of the brain, analysis of cerebrospinal fluid and examination of cerebral hemodynamics. In this case, the appointment of therapeutic therapy will depend on the overall clinical picture. To do this, use conservative, surgical methods and recovery therapy.
Definition of alternating syndromes
From the Latin language, alternating syndromes are translated as "opposite". This definition includes a complex of symptoms, which are described by signs of damage to the cranial nerves with central motor and sensory disturbances in another part of the body. Since paresis extends only to one half of the body, it is called hemiparesis (from the Latin "half"). Because ofidentical symptoms in alternating syndromes in neuralgia, they are also commonly called "cross syndromes".
Reasons for appearance
Alternating syndromes occur in humans as a result of a half lesion of the cerebral trunk.
The most common reasons for this are:
- Attack of a stroke. The most common cause that leads to a neurological syndrome. In most cases, a stroke occurs due to thromboembolism, spasms in the spine, basilar, and cerebral arteries. Hemorrhagic stroke occurs when bleeding from certain vessels.
- Beginning of extensive inflammation. These include: abscesses, meningoencephalitis, cerebral encephalitis of variable etiology with the spread of inflammation to stem tissues.
- Getting a head injury. Most often, the alternating syndrome occurs after receiving a fracture of the bones of the skull, which make up the posterior cranial fossa.
- Symptoms of alternating extra-stem spread syndrome are most often detected when there are problems with blood circulation in the middle cerebral, common or internal carotid artery.
Distinctive features of the disease
Fauville's alternating syndrome is characterized by lesions of most of the face. Pathology extends to 6 pairs of cranial nerves in a peripheral type in the area of the lesion. Also, in Fauville's syndrome, peripheral paresis leads to paralysis of the eye and limbs on the opposite side fromthe affected part of the body. Such a disease is included in the alternative group. In more detail, you can consider Fauville's syndrome in the photo above.
The disease in most cases occurs after thrombosis of the main artery. The syndrome was characterized in detail back in 1858 by the French scientist and physician of neurological diseases Fauville.
Main damage factors
Most often, some forms of infections lead to an alternating syndrome, among them Escherichia coli, streptococci, various bacteria that spread mainly in two ways: hematogenous and contact.
Fauville's syndrome in neurology appears hematogenously:
- due to metastatic abscesses that result from pneumonia, lung abscess, or infection of the valvular heart apparatus (endocarditis);
- with purulent lesions of the lungs, which is considered the most common among others;
- when non-compliance with the rules of hygiene and non-compliance with sanitary standards (administration of medications through a vein).
The source of the disease can only be determined in 80 percent of all cases. The symptoms of Fauville's syndrome are very pronounced.
Appearance by contact:
- due to the spread of a purulent lesion in the oral cavity, pharynx, eye socket or paranasal sinuses;
- infections that appear due to open damage to the cranium and the appearance of subdural hematomas.
Carrying out diagnostic measures
Fauville syndrome infection is diagnosed using the following procedures:
- MRI or CT - help the doctor to get more accurate and complete information about the lesion, are the main methods for diagnosing diseases of an infectious nature;
- examination of peripheral blood, determination of quality and components (erythrocytes, hemoglobin, leukocytes);
- research of possible malignant formations in the body (tumors), as well as neoplasms that are in the process of metastasis, chronic meningitis, stroke, hematoma;
- determination of the main source of infection of the patient.
Providing treatment
The choice of a method for treating Fauville's syndrome will directly depend on the general condition of the patient, the characteristics of the syndrome and its form of neglect. Depending on these parameters, the treating specialist will determine exactly which treatment method is best used in a particular case. Experts identify two methods of treating an infectious lesion:
- conservative;
- surgical.
Conservative treatment involves medication. But it is important to remember that medications cannot effectively affect the disease and get rid of a rapidly spreading infection, so they are rarely used in treatment.
Surgery is used only when an abscess capsule has formed (approximately 4 weeks after the appearancethe first symptoms of the disease) and in the presence of a threat of displacement of the brain sections. Most often, surgery is used to conduct a truly effective and high-quality treatment.
The operation is performed by draining the abscess through a hole in the bone tissue: MRI or CT equipment is required. In some cases, the operation has to be performed a second time. During the recovery period after surgery, the doctor without fail prescribes the patient to take strong antibiotics in a large dosage.
Additional Syndromes
Weber's syndrome is another alternating syndrome. It occurs as a result of the following processes:
- stroke;
- severe cerebral hemorrhages;
- presence of tumors;
- inflammatory process in the lining of the brain.
With Weber's syndrome, neurological pathologies extend to a greater extent to the base of the midbrain and to the nuclei or roots of the oculomotor nerve (the area that is responsible for coordinating a person in space, including bipedalism).
In the area of the lesion, violations of the visual system appear, on the opposite side there are problems with sensitivity and motor processes.
Area of Damage
With Weber's syndrome, the pathology spreads unevenly. The following symptoms are present in the affected area:
- strong eyelid trembling;
- mydriasis - dilation of the pupil, which has nothing to do with the reaction to light;
- divergent strabismus;
- there is a double image of surrounding objects in the eyes;
- difficulty focusing;
- displacement of the eyeball (bulging appears), sometimes the displacement occurs mainly on one side;
- complete or partial paralysis, which extends to the muscles of the eye.
The following symptoms are common on the other side:
- paralysis of the muscles of the face and tongue;
- sensitivity issues;
- uncontrollable cramps in limbs;
- hand bending problems;
- increase the tone of the flexor muscles in the arm, extensor muscles in the leg.
Parino Syndrome
Parino's syndrome is a pathology in which a sick person cannot independently move the eye up or down, which leads to the development of a tumor formation of the pineal gland, which passes with compression of the vertical center of gaze in the interstitial nucleus.
Pathology refers to the group of eye and pupil motility disorders. The clinical picture of the disease includes the following symptoms:
- upward gaze paralysis;
- pseudo-pupils of Argyle Robertson (accommodative paresis occurs, while you can see medium dilated pupils and determine the presence of dissociation brightly close);
- convergence-retraction nystagmus (in most cases occurs when trying to look up);
- eyelid retraction;
- gaze conjugation in one position.
Also inin some cases, balance problems occur, bilateral optic nerve edema appears.
Main causes of occurrence
Parino's syndrome appears due to spinal cord injury. Ischemic disorders or compression of the integument of the midbrain lead to such a violation. Most often, the syndrome occurs in the following people:
- young people who previously had tumors in the midbrain or pineal gland;
- women aged 20 to 30 with multiple sclerosis;
- in older people who had a stroke of the upper brain.
Other types of compression, damage or ischemia in the indicated places can provoke a hemorrhage in the midbrain, obstructive hydrocephalus. Extensive aneurysms and neoplasms of the posterior cranial fossa can also serve as the onset of Parino's syndrome.
Diagnostic measures are carried out in order to establish the main external signs of the disease. The doctor also sends the patient to undergo a full clinical examination in order to prevent the occurrence of any anatomical pathologies and other complications with the help of the results.
Treatment measures
Therapeutic therapy must first of all deal with the etiology of the syndrome. Bilateral recession of the inferior rectus muscle helps to release the upper gaze, improve convergence movement. Most often, specialists prescribe complex treatment using antibiotics and corticotherapy. If Parino's syndrome has a tumororigin, then surgery is accepted for treatment.
The main danger of such a syndrome is the defeat of neighboring parts of the body and the deterioration of the etiological condition. The main symptoms in most cases disappear for a very long time, within a few months.
But there were cases of rapid improvement in the patient's condition, normalization of intravenous pressure when using ventriculoperitoneal shunting. Complications occur in rare cases and are associated mainly with the etiology of the disease - benign tumors can begin to change, and pathogenic pathogens can spread to other parts of the central system.
