“Sixteen and a half”: a novel pontine neuro-ophthalmological syndrome
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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 , 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 , who reported 3 cases of this...
KeywordsHearing Loss Facial Nerve Palsy Medial Longitudinal Fasciculus Limb Paresis Pontine Infarct
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