Partial Weber Syndrome Presenting with Isolated Ptosis and Mild Contralateral Hemiparesis: A Case Report
Gabriela Queensanya Lienardy1*, Ketut Widyastuti2
Abstract
Introduction: Weber syndrome is one of the rare crossed paralysis syndromes, in which clinical findings provide important clues for lesion localization. It presents with ipsilateral oculomotor nerve palsy and contralateral hemiparesis, suggesting a ventromedial midbrain lesion, most commonly of ischemic origin. Case Report: A 62-year-old hypertensive woman presented with a sudden onset of left-sided weakness, difficulty opening the right eyelid, and slurred speech for 2 days. Neurological examination revealed right eye ptosis, left facial and hypoglossal nerve supranuclear palsies, left flaccid hemiparesis (MRC 4/5), and a positive left Babinski sign. Eyeball position, extraocular movements, and pupillary function were normal bilaterally. Neither hemorrhage nor infarction was visible on non-contrast head CT, while MRI was unavailable. The patient showed improvement after 5 days of treatment with citicoline, aspirin, clopidogrel, folic acid, amlodipine, candesartan, simvastatin, allopurinol, and physiotherapy. Discussion: Patient’s presentation was consistent with Weber syndrome, characterized by right oculomotor nerve palsy and left hemiparesis, allowing localization to the right ventromedial midbrain. Isolated ptosis with mild contralateral weakness suggested a partial Weber syndrome, likely caused by a small lesion affecting selective oculomotor fascicles and adjacent corticospinal and corticobulbar tracts. Non-contrast head CT is largely insensitive for detecting brainstem infarcts, especially small lesions. In the absence of hemorrhage, ischemic stroke treatment was initiated, resulting in clinical improvement. Conclusion: Weber syndrome may present as a partial form with isolated ptosis and mild contralateral hemiparesis. Careful clinical localization remains essential for diagnosis, particularly when brainstem infarcts are not typically visualized on CT imaging, and MRI is inaccessible.
Keywords
partial Weber syndrome; isolated ptosis; midbrain infarction; crossed paralysis
Cite This Article
Lienardy, G. Q., Widyastuti, K. (2026). Partial Weber Syndrome Presenting with Isolated Ptosis and Mild Contralateral Hemiparesis: A Case Report. International Journal of Scientific Advances (IJSCIA), Volume 7| Issue 2: Mar – Apr 2026, Pages 243-246 URL: https://www.ijscia.com/wp-content/uploads/2026/03/Volume7-Issue2-Mar-Apr-No.1038-243-246.pdf
Volume 7 | Issue 2: Mar – Apr 2026
