Millard-gubler syndrome (abducens-facial hemiplegia alternans)

General: Vascular, infectious, or tumorous lesion at the base of the pons affecting the nucl 353h78d ei of the sixth and seventh nerves and fibers of the pyramidal tract; demyelinating disease.

Ocular: Diplopia; esotropia; paralysis external rectus muscle (often bilateral); in unilateral cases, there is deviation of eyes to side opposite lesion and inability to move them toward side of lesion; abduction of eye prevented by destruction of sixth nerve nucleus; opposite eye cannot be voluntarily adducted but can converge and move in this position by rotatory and caloric stimulation.

Clinical: Ipsilateral facial paralysis; contralateral hemiplegia of arm and leg from involvement of pyramidal tract.

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