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Journal of Neurology

, Volume 258, Issue 7, pp 1347–1348 | Cite as

“Sixteen and a half”: a novel pontine neuro-ophthalmological syndrome

  • G. Cummins
  • A. O’Hare
  • R. Dunne
  • S. Connolly
  • K. O’Rourke
  • T. Lynch
Letter to the Editors

Dear Sirs,

Two neuro-ophthalmological syndromes due to paramedian pontine infarction have previously been described. The “one and a half” syndrome was first reported and named by Miller Fisher [1], and consists of horizontal gaze palsy combined with an ipsilateral inter-nuclear ophthalmoplegia (INO) resulting in loss of all horizontal eye movements except abduction of the contralateral eye. The causative lesion is usually within the ipsilateral pontine tegmentum and is due to involvement of the abducens nucleus plus the medial longitudinal fasciculus (MLF), or alternatively to involvement of the MLF plus the paramedian pontine reticular formation (PPRF). These structures lie in close proximity to the nucleus and intra-axial fasiculus of the facial nerve. Consequently, ipsilateral fascicular lower motor neurone facial nerve palsy may accompany the “one-and-a-half” syndrome. This situation was named the “eight and a half syndrome” by Eggenberger [2], who reported 3 cases of this...

Keywords

Hearing Loss Facial Nerve Palsy Medial Longitudinal Fasciculus Limb Paresis Pontine Infarct 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Fisher CM (1967) Some neuro-ophthalmological observations. J Neurol Neurosurg Psychiatry 30:383–392PubMedCrossRefGoogle Scholar
  2. 2.
    Eggenberger E (1998) Eight-and-a-half syndrome: one-and-a-half plus cranial nerve VII palsy. J Neuroophthalmol 18:114–116PubMedGoogle Scholar
  3. 3.
    Wall M, Wray S (1983) The one-and-a-half syndrome-a unilateral disorder of the pontine tegmentum: a study of 20 cases and review of the literature. Neurology 33:971–980PubMedGoogle Scholar
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    Kataoka S, Hori A, Shirakawa T, Hirose G (1997) Paramedian pontine infarction. Neurological/topographical correlation. Stroke 28:809–815PubMedCrossRefGoogle Scholar
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    Khwaja G, Chaudhry N, Gupta M, Chaudhury D, Kushwaha RS (2008) Acute onset combined unilateral 7th and 8th nerve cranial nerve palsy as a manifestation of anterior inferior cerebellar artery territory infarct. J Indian Acad Clin Med 9:198–200Google Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • G. Cummins
    • 1
  • A. O’Hare
    • 2
  • R. Dunne
    • 1
  • S. Connolly
    • 3
  • K. O’Rourke
    • 1
  • T. Lynch
    • 1
  1. 1.Dublin Neurological InstituteMater Misericordiae University HospitalDublin 7Ireland
  2. 2.Department of NeuroradiologyBeaumont HospitalDublin 9Ireland
  3. 3.Department of Clinical NeurophysiologySt. Vincent’s University HospitalDublin 4Ireland

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