[Classical brain stem syndrome. Definitions and history].

Area of Science:

• Neuroscience
• Neurology
• Ophthalmology

Context:

• Classical brain stem syndromes are crucial for neuro-ophthalmological diagnosis.
• Historical definitions of these syndromes in medical literature are often inaccurate.
• Understanding the evolution of these definitions is key to accurate clinical application.

Purpose:

• To conduct a medico-historical investigation of classical brain stem syndromes.
• To compare original descriptions and neuroanatomical findings with contemporary clinical knowledge.
• To clarify the definitions and diagnostic relevance of syndromes like Weber's, Benedikt's, Millard Gubler's, Foville's, Raymond Cestan's, Wallenberg's, Parinaud's, and Koerber Salus Elschnig's.

Summary:

• The study analyzes original publications from the last century and early this one, focusing on neuro-ophthalmological diagnosis and neuroanatomy.
• Key syndromes discussed include those involving III-nerve (Weber, Benedikt, Nothnagel Claude), VII-nerve (Millard Gubler, Foville), and VI-nerve (Raymond Cestan) palsies, as well as Wallenberg's syndrome.
• Parinaud's and Koerber Salus Elschnig's syndromes, though lacking long tract lesions, are also included due to their significant ocular and neurological signs indicating brain stem involvement.

Impact:

• Historical descriptions and neuroanatomical illustrations aid in assessing current clinical presentations of brain stem syndromes.
• Highlights discrepancies between historical definitions and modern clinical usage of certain syndromes, such as Parinaud's syndrome.
• Provides a foundation for refining diagnostic criteria and understanding the historical context of brain stem lesion localization.