Bilateral Nothnagel syndrome. Clinical and roentgenological observations

The clinical features of a patient with bilateral oculomotor palsy, ataxia, disturbance of memory, and hypokinesia are described. Pneumography and CT scanning showed dilation of the posterior portion of the third ventricle, indicating involvement of the postero-medial thalamic structures. The relation of this finding to the patient's amnesia and hypokinesia is briefly discussed. It is concluded that the patient suffered an infarction within the region served by penetrating branches which arise from the cephalad end of the basilar artery, probably including the mesencephalic artery.