title: One and one-half syndrome with supranuclear facial weakness: magnetic resonance imaging localization.
abstract: 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.
authors.affiliation: Department of Neurology, University of Colorado School of Medicine, and the Denver Veterans Affairs Medical Center, 80262, USA.
authors.forename: C A
authors.initials: CA
authors.lastname: Anderson
authors.forename: E
authors.initials: E
authors.lastname: Sandberg
authors.forename: C M
authors.initials: CM
authors.lastname: Filley
authors.forename: S L
authors.initials: SL
authors.lastname: Harris
authors.forename: K L
authors.initials: KL
authors.lastname: Tyler
mesh_terms: 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