Pontine hemorrhage presenting as Foville’s syndrome


  • Mary Stephen Department of Ophthalmology, JIPMER, Puducherry, India
  • Jayasri . Department of Ophthalmology, JIPMER, Puducherry, India
  • Harigaravelu P. J. Department of Surgery, IGGGH and RI, Puducherry, India
  • Baranitharan . Department of Radio-diagnosis, Osmania Hospital, Hyderabad, Telangana, India




Foville’s syndrome, Pontine hemorrhage, Diplopia, Lagophthalmos, Hemiparesis


Foville’s syndrome, also known as inferior medial pontine syndrome is one of the rare brainstem stroke syndromes with only few cases reported worldwide occurring due to involvement of the infero-medial aspect of pons. Condition is characterised by various cluster of neurological features as a result of defect in multiple vital areas like cortico spinal tract, medial lemniscus, middle cerebral peduncle, facial nerve and abducens nerve involvement. We reported one such rare case of a patient with no known systemic co-morbidity, who presented with sudden onset diplopia, lagophthalmos and contralateral weakness of limbs. On evaluation with computed tomography imaging, hemorrhage at the level of inferior pons was found. Patient subsequently treated and commenced on physiotherapy for rehabilitation. 


Brogna C, Fiengo L, Türe U. Achille Louis Foville’s atlas of brain anatomy and the Defoville syndrome. Neurosurgery. 2012;70(5):1265-73.

Silverman IE, Liu GT, Volpe NJ, Galetta SL. The crossed paralyses. The original brain-stem syndromes of Millard-Gubler, Foville, Weber and Raymond-Cestan. Arch Neurol. 1995;52(6):635-8.

Raggio CC, Dasgupta A. Three cases of Spontaneous vertebral artery dissection (SVAD), resulting in two cases of Wallenberg syndrome and one case of Foville syndrome in young, healthy men. BMJ Case Rep. 2014;2014:2014203945.

Khazaal O, Marquez DL, Naqvi IA. Foville Syndrome. Treasure Island (FL): StatPearls Publishing; 2021.

Bedi HK, Devpura JC, Bomb BS. Clinical tuberculoma of pons presenting as Foville’s syndrome. J Indian Med Assoc. 1973;61(4):184-5.

Radiopaedia.org. fact sheet: Inferior medial pontine syndrome, 2021. Available at: https://radiopaedia.org/articles/inferior-medial-pontine-syndrome. Accessed on 12 May 2021.

Cheng HC, Yen MY, Wang AG. Foville’s syndrome with ipsilateral internuclear ophthalmoplegia due to spontaneous pontine hemorrhage. Taiwan J Ophthalmol. 2013;3(2):75-7.






Case Reports