[Fisher's one and half syndrome with facial palsy as clinical presentation of giant cell temporal arteritis].
An ischemic stroke in an old patient is commonly due to thrombosis or embolism. A restriction in the differential diagnosis and not considering another etiology could occasion the loss of effective therapy and prevent major complications. We report the case of a patient who suffering from systemic symptoms for a few months, was admitted to the hospital with the one and a half syndrome described by Fisher, together with right facial palsy, both products of an ischemic pontine lesion. Bilateral biopsies of the temporal arteries were diagnostic of temporal arteritis and MRN of the cranium confirmed multiple ischemic lesions involving the pons. In conclusion, the diverse clinical presentations of temporal arteritis oblige us to consider it among the etiological options in older patients with neurological signs affecting the vertebral-basilar system, accompanied by systemic signs and symptoms and a high VSG. To avoid anterior ischemic optic neuropathy and other complications a quick diagnosis and treatment are necessary.
Zamarbide
I D
ID
Servicio de Neurología, Hospital Privado de Comunidad, Mar del Plata, Argentina.
Maxit
M J
MJ
D000368:Aged; D000369:Aged, 80 and over; D005158:Facial Paralysis / Q000209:etiology* / Q000473:pathology; D005260:Female; D013700:Giant Cell Arteritis / Q000150:complications* / Q000473:pathology; D006801:Humans; D015835:Ocular Motility Disorders / Q000209:etiology*; D013577:Syndrome; D013699:Temporal Arteries