Two patients with abducens nerve palsy and crossed hemiplegia (Raymond syndrome)

We report 2 patients of alternating hemiplegia with abducens nerve palsy. One patient was also complicated by contralateral supranuclear facial nerve palsy. MRI showed an infarct involving the paramedian and lateral area of the pontine basis in both patients. We considered that corticospinal tract and infraabducens nerve fibers were involved in both patients, and that the corticobulbar tract was involved in 1 patient with supranuclear facial nerve palsy. Although supranuclear facial nerve palsy was not found in the other patient, we speculated that supranucler facial nerve fibers might pass mainly through the aberrant pyramidal tract in this patient.