title: One-and-a-half syndrome--two cases.
abstract: One-and-a-half syndrome is characterized by combination of the clinical features of unilateral horizontal gaze palsy and internuclear ophthalmoplegia. The common symptoms are double vision and oscillopsia. The lesion is located in the paramedian pontine reticular formation, involving the centre of horizontal gaze and medial longitudinal fasciculus. More extensive brainstem damage may result in additional neurological signs. The most frequent underlying diseases are vascular insults, multiple sclerosis, and brainstem tumor. We present two cases of one-and-a-half syndrome. Both patients had lacunar infarction in the paramedian pontine tegmentum, revealed by MRI. The first patient had isolated eye movement disorder, while the second had additional nuclear-type facial paresis. In the first case brainstem evoked potentials indicated brainstem damage, in the second patient it was normal. Ocular symptoms improved within some days in both patients.
authors.affiliation: Semmelweis University, Department of Neurology, Budapest. sandor@neur.sote.hu
authors.forename: Sándor
authors.initials: S
authors.lastname: Ilniczky
authors.forename: Anita
authors.initials: A
authors.lastname: Kamondi
authors.forename: György
authors.initials: G
authors.lastname: Várallyay
authors.forename: Barbara
authors.initials: B
authors.lastname: Gaal
authors.forename: Agnes
authors.initials: A
authors.lastname: Palásti
authors.forename: Szilvia
authors.initials: S
authors.lastname: Gulyás
authors.forename: Imre
authors.initials: I
authors.lastname: Szirmai
mesh_terms: D000368:Aged; D002544:Cerebral Infarction / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D038524:Diffusion Magnetic Resonance Imaging; D004172:Diplopia / Q000209:etiology; D005074:Evoked Potentials, Visual; D005158:Facial Paralysis / Q000209:etiology; D006801:Humans; D008297:Male; D015835:Ocular Motility Disorders / Q000209:etiology*; D009886:Ophthalmoplegia / Q000209:etiology; D011149:Pons / Q000473:pathology*; D012154:Reticular Formation / Q000473:pathology*; D013577:Syndrome; D013681:Tegmentum Mesencephali / Q000473:pathology