Regression of Benedikt's syndrome after single-stage removal of mesencephalic cavernoma and temporal meningioma: A case report

We herein report a unique association of midbrain cavernoma and Benedikt's syndrome (BS) that was reversed after microsurgical removal of the lesion. BS was originally described by Moritz Benedikt in 1889, characterized by the presence of an oculomotor nerve palsy and cerebellar ataxia including tremor and ascribed clinical constellation of signs to a lesion of the cerebral peduncle [1]. Subsequently, Charcot [2] and de la Tourette and Charcot [2] reported other cases, and in the latter case, involvement of the red nucleus, substantia nigra, third nerve root and sparing the cerebral peduncle were reported [3]. In this report, the author questioned the involvement of the corticospinal tract as a key feature of BS [3]. By that time, midbrain ischemic lesions and tuberculomas appeared to be the most frequent causes of BS, which was never reversible when midbrain structures were disrupted. Our case helps to elucidate the clinicopathologic characteristics of BS, the potential reversibility of which may indicate surgery even in severely disabled patients with noninfiltrating midbrain mass lesions.