Posttraumatic Benedikt's syndrome: a rare entity with unclear anatomopathological correlations

This study sought to present a very rare case of a posttraumatic midbrain lesion producing a debilitating constellation of symptoms identified as Benedikt's syndrome.

A 20-year-old woman with traumatic brain injury presented with ipsilateral internal and external ophthalmoplegia, and contralateral hemiataxia, proprioception disturbances, hypertonicity, slight hemiparesis, and hyperactive tendon reflexes. A bibliographic search was performed in PubMed.

Neuroimaging revealed a left midbrain lesion at the level of the superior colliculi. In the literature, virtually all Benedikt's syndrome cases, which are rare anyway, are due to midbrain infarcts (basilar or posterior cerebral artery branches). There is only one case from 1963, reported as a posttraumatic Benedikt-type dyskinesia (French language). The historical evolution of the anatomopathologic correlations of the syndrome is also discussed.

Benedikt's syndrome is a very rare condition, usually of vascular etiology. Our case is just the second one of traumatic pathogenesis ever reported, the first in the English language literature.