Paralisia do olhar conjugado lateral associada a oftalmoplegia internuclear unilateral em hemorragia mesencéfalo-pontina alta: relato de um caso

Fontanari, Juliano Luís; Vaitses, Vivian Denise Cazerta; Cruz, Carlos E. R Nova; Tichauer, Thomas A. T; Lisboa, Liana; Souza, Emanuel Soares de

doi:10.1590/s0004-282x1986000400009

Arq. Neuro-Psiquiatr.

1986

DOI: 10.1590/s0004-282x1986000400009

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Paralisia do olhar conjugado lateral associada a oftalmoplegia internuclear unilateral em hemorragia mesencéfalo-pontina alta: relato de um caso

Juliano Luís Fontanari

Vivian Denise Cazerta Vaitses

Carlos E. R Nova Cruz

et al.

Abstract: The authors report a case of right midbrain and high pons haemorrhage with complete external ophthalmoplegia, except bilateral convergence, voluntary and automatic-reflex abduction of the left eye and adduction of this eye with vestibulo-ocular reflex ("one-and-a-half syndrome"). There is voluntary-automatic dissociation of the eyelids motricity and the vertical gaze. Still, there is sensitive-motor hemiplegia at left and asterixis.

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“…The contralateral vestibular nuclei (these nuclei are responsible for the vestibuloocular reflexes) and the ipsilateral prepositus hypoglossi nucleus (involved with foveal pursuit) constitute the excitatory pathways to abducens nucleus 6101719 . The ipsilateral vestibular nuclei and the contralateral propositus hypoglossi nucleus constitute the inhibitory pathways to the abducens nucleus 6 ' 101719 .…”

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Pontine tegmentum hematoma: a case report with the "one-and-a-half "syndrome without pyramidal tract deficit

Azevedo

1995

Arq. Neuro-Psiquiatr.

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SUMMARY -The author reports the case of a 54-year-old male patient with a pontine hematoma and with the one-and-a-half syndrome, cerebellar ataxia and no signs of pyramidal tract involvement. The absence of involvement of the pyramidal tract in the case reported herein is likely due to variation in the vascular anatomy of the pons. The pathophysiologic mechanisms of the one-and-a-half syndrome and of the clinical findings recorded are discussed.KEY WORDS: pontine hemorrhage, one-and-a-half syndrome, pyramidal tract.Hematoma tegmentar pontino: relato de caso com a síndrome "onc-and-a-half" e sem déficit piramidal RESUMO -O autor relata o caso de um paciente de sexo masculino de 54 anos com hematoma pontino que se manifestou por síndrome "one-and-a-half" e ataxia cerebelar mas sem sinais de acometimento do trato piramidal. A ausência de acometimento do trato piramidal é decorrente possivelmente de uma variação da anatomia vascular PALAVRAS-CHAVE: hemorragia pontina, síndrome one-and-a-half, trato piramidal.

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confidence: 99%

Pontine tegmentum hematoma: a case report with the "one-and-a-half "syndrome without pyramidal tract deficit

Azevedo

1995

Arq. Neuro-Psiquiatr.

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Síndrome 'one-and-a-half': considerações anatomoclínicas a propósito de um caso

André

Castro

Vincent

et al. 1989

Arq. Neuro-Psiquiatr.

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A 36 years-old man was admitted in September 1987. For 5 years he suffered from 4 recurrent episodes of throbbing headache, tinnitus, nausea, diplopia and divergent strabismus to which a facial palsy was recently added. In all episodes, the symptoms disappeared spontaneously and completely. A neuro-ophthalmological examination at admission disclosed an exotropia of the right eye, gaze paralysis to the left, paralysis of adduction of the left eye and preserved right eye abduction which triggered a rhythmic horizontal nystagmus. The upward and downward gazes and the convergence were well preserved. Moreover, there was a left peripheral facial palsy, and Babinski sign at the right side. Auditory evoked potentials were slowed at the mesencephalopontine transition. CT scan showed a low-density area with no contrast enhancement at the left pontine tegmentum and a left anterolateral atrophy of the pons. CSF examination showed increase in protein content and increase in the IgG content. Additional investigation included a dopplerometry of the cervical arteries, a panangiography and a bidimensional echocardiography which were normal. Diagnosis of one-and-a-half syndrome was made, possibly secondary to multiple sclerosis, and immunossuppressive therapy was initiated.

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Paralisia do olhar conjugado lateral associada a oftalmoplegia internuclear unilateral em hemorragia mesencéfalo-pontina alta: relato de um caso

Cited by 2 publications

References 17 publications

Pontine tegmentum hematoma: a case report with the "one-and-a-half "syndrome without pyramidal tract deficit

Pontine tegmentum hematoma: a case report with the "one-and-a-half "syndrome without pyramidal tract deficit

Síndrome 'one-and-a-half': considerações anatomoclínicas a propósito de um caso

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