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What is Examination of a patient shows abducens nerve paresis, ipsilateral facial nerve paresis and contralateral hemiparesis. What is the MOST likely diagnosis in this patient? and explain in detail?
In patients with Millard Gubler syndrome, the lesion is in the ventral pa of the brainstem and involves the sixth nerve, facial nerve and the pyramidal tract. This results in ipsilateral abducens and facial nerve paresis and contralateral hemiparesis. In Raymond's syndrome the lesion involves only the sixth cranial nerve and the pyramidal tract. Thus patients presents with sixth nerve paresis and contralateral hemiparesis. Ref: Textbook of Ophthalmology edited by Sunita Agarwal,page 342.