One and one-half syndrome with supranuclear facial weakness: magnetic resonance imaging localization.
OBJECTIVE
To provide clinicoanatomical correlation for a small pontine tegmental ischemic stroke producing the one and one-half syndrome associated with supranuclear facial weakness.


METHODS
Case report.


METHODS
Tertiary care center.


METHODS
A 70-year-old man developed left-sided facial weakness sparing the forehead, a left internuclear ophthalmoplegia, and a complete left horizontal gaze palsy immediately after percutaneous transluminal coronary angioplasty. Magnetic resonance imaging demonstrated a small lesion in the left paramedian aspect of the dorsal pontine tegmentum.


RESULTS
Electromyographic findings were consistent with supranuclear facial involvement. The patient had nearly complete recovery after 1 year.


CONCLUSIONS
To our knowledge, this is the first report of supranuclear facial weakness in association with the one and one-half syndrome. The location of the lesion provides evidence of the existence of corticofugal fibers that extend to the facial nucleus in the dorsal paramedian pontine tegmentum.
Anderson
C A
CA
Department of Neurology, University of Colorado School of Medicine, and the Denver Veterans Affairs Medical Center, 80262, USA.
Sandberg
E
E
Filley
C M
CM
Harris
S L
SL
Tyler
K L
KL
D000368:Aged; D005154:Facial Nerve / Q000473:pathology / Q000503:physiopathology; D005158:Facial Paralysis / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D018908:Muscle Weakness / Q000473:pathology / Q000503:physiopathology; D009434:Neural Pathways / Q000473:pathology / Q000503:physiopathology; D009886:Ophthalmoplegia / Q000473:pathology* / Q000503:physiopathology; D011149:Pons / Q000098:blood supply / Q000473:pathology* / Q000503:physiopathology; D020521:Stroke / Q000473:pathology* / Q000503:physiopathology