Dube Mukesh, Dani Raunak, Dubey Ayush, Chouksey Dinesh
Department of Neurology, Sri Aurobindo Medical College & P.G. Institute, 4th Floor, Sanwer Road, Indore, MP, 453555, India.
J Med Case Rep. 2019 Feb 15;13(1):35. doi: 10.1186/s13256-019-1980-4.
In the list of named numerical neuro-ophthalmological syndromes, such as one-and-a-half syndrome and others, we report for the first time twenty-and-a-half syndrome, which is characterized by one-and-a-half syndrome with bilateral seventh and right fifth nerve palsy (1.5 + 7 + 7 + 5 = 20.5) in a patient with ischemic stroke.
A 45-year-old Asian Hindu woman presented with vomiting and imbalance of 1 day's duration. She had left-sided ataxic hemiparesis with one-and-a-half syndrome with bilateral seventh and right fifth nerve palsy. Magnetic resonance imaging of her brain revealed acute non-hemorrhagic infarct in the right posterolateral aspect of pons and medulla, with normal brain vessels angiography. We described her disorder as twenty-and-a-half syndrome. She was put on antiplatelet therapy.
Twenty-and-a-half syndrome is reported for the first time. It is due to posterior circulation stroke; in our case, it was due to lacunar infarcts in the pons and medulla, manifesting as one-and-a-half syndrome with bilateral seventh and right fifth nerve palsy.
在已命名的数字神经性眼科综合征列表中，如一个半综合征等，我们首次报告了二十个半综合征，其特征为一名缺血性中风患者出现一个半综合征合并双侧第七颅神经和右侧第五颅神经麻痹（1.5 + 7 + 7 + 5 = 20.5）。
一名45岁的亚洲印度教女性，因持续1天的呕吐和失衡前来就诊。她有左侧共济失调性偏瘫，伴有一个半综合征合并双侧第七颅神经和右侧第五颅神经麻痹。其脑部磁共振成像显示脑桥和延髓右后外侧急性非出血性梗死，脑血管造影正常。我们将她的病症描述为二十个半综合征。她接受了抗血小板治疗。
首次报告了二十个半综合征。它是由后循环中风引起的；在我们的病例中，是由于脑桥和延髓的腔隙性梗死，表现为一个半综合征合并双侧第七颅神经和右侧第五颅神经麻痹。
