3 replies
  1. anders
    anders says:

    Hi,
    couldn’t the neuroanatomic localization, just considering the anamnesis and neurological exam, as well be in the left part of the brainstem?
    If not, then why?
    Best regards, Anders

    • neuropetvet
      neuropetvet says:

      Hi, Anders. Thanks for you comment/question! Left hemiparesis and left-sided postural reaction deficits certainly can be seen with left brainstem lesions. Brainstem dysfunction would also be possible if the absent menace response was due to facial nerve dysfunction. Absent menace response can be due to disease affecting the visual pathway, contralateral forebrain, ipsilateral facial nerve, or ipsilateral cerebellum. The absent menace response here was thought to most likely be due to contralateral forebrain dysfunction since vision & palpebral were intact and there were no cerebellar signs. There were also no other brainstem-specific abnormalities on neurologic abnormalities so I localized to right forebrain (prosencephalon). Hope this helps!

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