Medial lemniscus

The medial lemniscus, also known as Reil's band or Reil's ribbon, is a pathway in the brainstem, that carries sensory information from the gracile and cuneate nuclei to the thalamus.

After neurons carrying proprioceptive or touch information synapse at the gracile and cuneate nuclei, axons from secondary neurons travel up the brainstem as the medial lemniscus on the contralateral (opposite) side. It is part of the posterior column-medial lemniscus system, which transmits touch, as well as the pathway for proprioception.

The medial lemniscus axons synapse at the ventral posterolateral nucleus of the thalamus.

Location of the medial lemniscus through the brainstem

The cuneate and gracile nuclei reside at the closed (lower) medulla, so the lemniscus isn't formed at this level. Fibres from these nuclei will pass to the contralateral side of the brainstem, as the internal arcuate fibres.

At the open medulla (further up the brainstem), the medial lemniscus contains axons from the trigeminal nerve (which supplies the head region), as well as the arms and legs. It sits very close to the midline, at the same orientation of the midline, with head fibres more dorsal (closer to the back), towards the fourth ventricle.

By mid-pons, the medial lemniscus has rotated. Fibres from the head are medial, fibres from the leg are lateral.

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