Post-Surgical Oculopalatal Tremor with Facial Diplegia and Bilateral Horizontal Gaze Palsy

An otherwise healthy female presented initially at age 49 with the acute onset of right sixth and seventh nerve palsies and left; hemiparesis. Imaging studies revealed two cavernomas within the right pons including one in the region of the facial colliculus. Her deficits improved but did not resolve over several months. Five years after her initial presentation she developed recurrent right facial palsy and dysphagia. Imaging revealed acute pontine hemorrhage and she underwent surgical resection of the cavernoma.