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Case Reports in Neurological Medicine
Volume 2012 (2012), Article ID 583123, 3 pages
http://dx.doi.org/10.1155/2012/583123
Case Report

A Case of Classic Raymond Syndrome

1Department of Neurology, Temple University School of Medicine, 3401 North Broad Street, C525, Philadelphia, PA 19140, USA
2Department of Pharmacology, Temple University School of Medicine, Philadelphia, PA 19140, USA

Received 31 March 2012; Accepted 10 July 2012

Academic Editors: M. Filosto, C.-C. Huang, and P. Sandroni

Copyright © 2012 Nicholas George Zaorsky and Jin Jun Luo. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Classic Raymond syndrome consists of ipsilateral abducens impairment, contralateral central facial paresis, and contralateral hemiparesis. However, subsequent clinical observations argued on the presentation of facial involvement. To validate this entity, we present a case of classic Raymond syndrome with contralateral facial paresis. A 50 year-old man experienced acute onset of horizontal diplopia, left mouth drooling and left-sided weakness. Neurological examination showed he had right abducens nerve palsy, left-sided paresis of the lower part of the face and limbs, and left hyperreflexia. A brain MRI showed a subacute infarct in the right mid-pons. The findings were consistent with those of classic Raymond syndrome. To date, only a few cases of Raymond syndrome, commonly without facial involvement, have been reported. Our case is a validation of classic Raymond syndrome with contralateral facial paresis. We propose the concept of two types of Raymond syndrome: (1) the classic type, which may be produced by a lesion in the mid-pons involving the ipsilateral abducens fascicle and undecussated corticofacial and corticospinal fibers; and (2) the common type, which may be produced by a lesion involving the ipsilateral abducens fascicle and undecussated corticospinal fibers but sparing the corticofacial fibers.