Millard-Gubler Syndrome in a Patient with Preeclampsia. Case Report and Review of Combined Intra- and Extra-Axial Facial and Abducens Nerve Injuries

ABSTRACT

Millard-Gubler syndrome is a pontine syndrome caused by a lesion in the lower pons region. It is characterised by ipsilateral facial paralysis and VI paresis and contralateral brachiocrural palsy. We present the case of a female patient, G4P2A1, at 21 weeks of gestation, with preeclampsia, complaints of blurred vision, diplopia, and right hemiparesis, in whom a clinical diagnosis of Millard-Gubler syndrome was made. Neuroimaging showed an intraparenchymal haemorrhage towards the central portion of the bulbopontine junction. An extensive aetiological study was carried out to determine the cause of the hypertensive disorder syndrome during pregnancy. The patient improved satisfactorily from the neurological deficit after delivery of an early stillbirth.

KEYWORDS:

• Millard-gubler syndrome
• preeclampsia
• hypertension
• pontine haemorrhage
• pregnant
• cerebrovascular disease
• sixth and seventh cranial nerve palsies

Authors’ contributions

All authors participated in the construction of this case report. The article was researched and written by Dr Sanchez and Dr Bautista, with the supervision of Dr Bonilla and Dr Salamanca who assisted with edits and guidance.

Consent for publication

The patient authorised the publication of the report and signed an informed consent form.

Ethics approval and consent to participate

This research was considered to have minimum risk. It adhered to the ethical principles of the Declaration of Helsinki.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

Case report based on clinical chart data, patient observation, and analysis of diagnostic tests.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.