Eight-and-a-half syndrome: a rare potentially life-threatening disease

Mesina, Bryan Vincent Q.; Sosuan, George Michael N; Reyes, Karen B

doi:10.3205/oc000086

Cited by 6 publications

(4 citation statements)

References 10 publications

(33 reference statements)

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“…The eight-and-a-half syndrome, as a special and uncommon type of the dorsolateral medullary syndrome combined with oculomotor abnormalities, was first described by Eggenberger in 1998. [ 9 ] It refers to coupled horizontal gaze paralysis and INO plus ipsilateral seventh cranial nerve paralysis. [ 10 ] It is a rare pontine neuro-ophthalmic syndrome.…”

Section: Discussionmentioning

confidence: 99%

“…[ 10 ] It is a rare pontine neuro-ophthalmic syndrome. [ 9 ] Dorsolateral medullary syndrome combined with eight-and-a-half syndromes is much rarer and, therefore, its recognition has considerable diagnostic value. [ 11 ] Conjugate horizontal gaze is a binocular movement that synchronizes the eyes in one direction of gaze, and these motor controls originate in the brain and brainstem.…”

Section: Discussionmentioning

confidence: 99%

“…This lesion may cause ipsilateral peripheral facial palsy, called the eight-and-a-half syndrome. [ 9 ] Some patients also have other clinical manifestations. [ 14 ] Thus, identification of this syndrome allows precise localization of the lesion to the ipsilateral side of the subpontine tegmentum.…”

Section: Discussionmentioning

confidence: 99%

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Case report: Lateral medullary syndrome with eight-and-a-half syndromes

Zuo,

Zhao,

Zhao

et al. 2024

Medicine

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Rationale: Lateral medullary syndrome is caused by atherosclerosis or embolism of the vertebral artery and its branches or the posterior inferior cerebellar artery (PICA).The eight-and-a-half syndrome is a rare pontocerebellar nerve-ocular syndrome presenting as a one-and-a-half syndrome plus ipsilateral seventh cerebral nerve palsy. The dorsolateral medullary syndrome combined with the eight-and-a-half syndromes is even rarer, so it is important to recognize the features of the classical brainstem syndrome and the eight-and-a-half syndromes. Patient concerns: Most patients with dorsolateral medullary syndrome combined with eight-and-a-half syndromes have a good prognosis, with recovery occurring within a few weeks to a few months, although a few patients may take longer to recover. Diagnosis interventions: In the course of disease development, the patient developed dysarthria, dysphagia, hypothermia, ipsilateral Horner sign and ataxia. Computed tomography was performed which showed cerebral infarction in the left brainstem. Cranial diffusion-weighted imaging + magnetic resonance angiography showed acute infarction in the left cerebellar hemisphere, with a high probability of severe stenosis or occlusion in the intracranial and proximal segments of the basilar arteries. This supports the diagnosis of dorsolateral medullary syndrome. The patient’s limited adduction and abduction of the left eye and limited adduction of the right eye, combined with peripheral paralysis of the affected lateral nerve, supported the diagnosis of eight-and-a-half syndromes. The administration of antiplatelet and anti-ester fixation treatment can effectively improve the symptoms and shorten the course of the disease. Outcomes: After antiplatelet and anti-ester fixation treatment, the symptoms improved and the patient was discharged. Lessons: Dorsolateral medullary syndrome combined with eight-and-a-half syndromes is a rare clinical condition, and therefore more attention should be paid to the early diagnosis and treatment of such patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Case report: Lateral medullary syndrome with eight-and-a-half syndromes

Zuo,

Zhao,

Zhao

et al. 2024

Medicine

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“…3 PPRF is also known as Para Abducens nucleus that involves for coordinating horizontal eye movement and saccades. 4 When the lesion affects both MLF and PPRF it represents one and half syndrome. One represents PPRF lesion and half represents MLF lesion with INO giving rise to ipsilateral conjugate horizontal gaze palsy.…”

Section: Discussionmentioning

confidence: 99%