The facial nerve exits the brain stem from the pontobulbar
sulcus on the upper edge of the upper olive fossa, of which the central segment clings to the pontine surface, leaves the brain stem after 8-10 mm away outwards, and then migrates to the cisternal segment of the facial nerve through the Obsterteiner-Redlich Transition Zone (TZ) of about 2mm.
estimated that the pontobulbar
region in NB is affected by focal lesions in 40% of cases and Lee et al.
De estos, el 75% se ubican en la fosa posterior en relacion a la linea media frente a la union pontobulbar
. De los intracraniales solo el 25% son supratentoriales, de ubicacion fuera de la linea media adyacentes a los lobulos frontales (11).
Brown-Vialetto-Van Laere syndrome is a rare autosomal recessive neurologic disorder of pontobulbar
motor neurons (VII, IX, X, XI, and XII) with progressive facial weakness, dysphagia, tongue amyotrophy (Figure 2(e)), fasciculations, and sensorineural deafness in childhood [74, 75].
Moreover, he can also be diagnosed with VZV brainstem encephalitis according to CSF evidence of VZV and pontobulbar
involvement on brain MRI.