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Weber's syndrome

Weber's syndrome
File:Weber's syndrome.svg
Midbrain cross section showing lesion
Classification and external resources
ICD-10 G46.3
ICD-9 344.89
DiseasesDB 31247
NCI Weber's syndrome
Patient UK Weber's syndrome
MeSH D020526

Weber's syndrome (superior alternating hemiplegia) is a form of stroke characterized by the presence of an ipsilateral oculomotor nerve palsy and contralateral hemiparesis or hemiplegia.

Cause and presentation

This lesion is usually unilateral and affects several structures in the midbrain including:

Structure damaged Effect
substantia nigra contralateral parkinsonism because its dopaminergic projections to the basal ganglia innervate the ipsilateral hemisphere motor field, leading to a movement disorder of the contralateral body.
corticospinal fibers contralateral hemiparesis and typical upper motor neuron findings. It is contralateral because it occurs before the decussation in the medulla.
corticobulbar tract difficulty with contralateral lower facial muscles and hypoglossal nerve functions
oculomotor nerve fibers ipsilateral oculomotor nerve palsy with a drooping eyelid and fixed wide pupil pointed down and out. This leads to diplopia
File:Human brainstem blood supply description.JPG
Human brainstem blood supply description. Posterior cerebral artery is #6, and midbrain is behind it.

It is caused by midbrain infarction as a result of occlusion of the paramedian branches of the posterior cerebral artery or of basilar bifurcation perforating arteries.[1]


It carries the name of Sir Hermann David Weber, a German-born physician working in London, who described the condition in 1863.[2][3] It is unrelated to Sturge-Weber syndrome, Klippel-Trenaunay-Weber syndrome or Osler-Weber-Rendu syndrome.


  1. ^ Weber's syndrome at GPnotebook
  2. ^ Weber HD (1863). "A contribution to the pathology of the crura cerebri". Medico-Chirurgical Transactions 46: 121–139. 
  3. ^ Weber's syndrome at Who Named It?

External links